Ether Compounds for Treatment of Complement Mediated Disorders

ABSTRACT

Compounds, methods of use, and processes for making inhibitors of complement factor D comprising Formula I, or a pharmaceutically acceptable salt or composition thereof wherein R 12  or R 13  on the A group is an ether (R 32 ) are provided. The inhibitors described herein target factor D and inhibit or regulate the complement cascade at an early and essential point in the alternative complement pathway, and reduce factor D&#39;s ability to modulate the classical and lectin complement pathways. The inhibitors of factor D described herein are capable of reducing the excessive activation of complement, which has been linked to certain autoimmune, inflammatory, and neurodegenerative diseases, as well as ischemia-reperfusion injury and cancer.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims the benefit of provisional U.S. Application No.61/944,189, filed Feb. 25, 2014, provisional U.S. Application No.62/022,916, filed Jul. 10, 2014, and provisional U.S. Application62/046,783, filed Sep. 5, 2014. The entirety of each of theseapplications is hereby incorporated by reference for all purposes.

BACKGROUND

The complement system is a part of the innate immune system which doesnot adapt to changes over the course of the host's life, but isrecruited and used by the adaptive immune system. For example, itassists, or complements, the ability of antibodies and phagocytic cellsto clear pathogens. This sophisticated regulatory pathway allows rapidreaction to pathogenic organisms while protecting host cells fromdestruction. Over thirty proteins and protein fragments make up thecomplement system. These proteins act through opsonization (enhancingphaogytosis of antigens), chemotaxis (attracting macrophages andneutrophils), cell lysis (rupturing membranes of foreign cells) andagglutination (clustering and binding of pathogens together).

The complement system has three pathways: classical, alternative andlectin. Complement factor D plays an early and central role inactivation of the alternative pathway of the complement cascade.Activation of the alternative complement pathway is initiated byspontaneous hydrolysis of a thioester bond within C3 to produce C3(H₂O),which associates with factor α to form the C3(H₂O)B complex. Complementfactor D acts to cleave factor α within the C3(H₂O)B complex to form Baand Bb. The Bb fragment remains associated with C3(H₂O) to form thealternative pathway C3 convertase C3(H₂O)Bb. Additionally, C3b generatedby any of the C3 convertases also associates with factor α to form C3bB,which factor D cleaves to generate the later stage alternative pathwayC3 convertase C3bBb. This latter form of the alternative pathway C3convertase may provide important downstream amplification within allthree of the defined complement pathways, leading ultimately to therecruitment and assembly of additional factors in the complement cascadepathway, including the cleavage of C5 to C5a and C5b. C5b acts in theassembly of factors C6, C7, C8, and C9 into the membrane attack complex,which can destroy pathogenic cells by lysing the cell.

The dysfunction of or excessive activation of complement has been linkedto certain autoimmune, inflammatory, and neurodegenerative diseases, aswell as ischemia-reperfusion injury and cancer. For example, activationof the alternative pathway of the complement cascade contributes to theproduction of C3a and C5a, both potent anaphylatoxins, which also haveroles in a number of inflammatory disorders. Therefore, in someinstances, it is desirable to decrease the response of the complementpathway, including the alternative complement pathway. Some examples ofdisorders mediated by the complement pathway include age-related maculardegeneration (AMD), paroxysmal nocturnal hemoglobinuria (PNH), multiplesclerosis, and rheumatoid arthritis.

Age-related macular degeneration (AMD) is a leading cause of vision lossin industrialized countries. Based on a number of genetic studies, thereis evidence of the link between the complement cascade and maculardegeneration. Individuals with mutations in the gene encoding complementfactor H have a fivefold increased risk of macular degeneration andindividuals with mutations in other complement factor genes also have anincreased risk of AMD. Individuals with mutant factor H also haveincreased levels of C-reactive protein, a marker of inflammation.Without adequate functioning factor H, the alternative pathway of thecomplement cascade is overly activated leading to cellular damage.Inhibition of the alternative pathway is thus desired.

Paroxysmal nocturnal hemoglobinuria (PNH) is a non-malignant,hematological disorder characterized by the expansion of hematopoieticstem cells and progeny mature blood cells which are deficient in somesurface proteins. PNH erythrocytes are not capable of modulating theirsurface complement activation, which leads to the typical hallmark ofPNH—the chronic activation of complement mediated intravascular anemia.Currently, only one product, the anti-C5 monoclonal antibody eculizumab,has been approved in the U.S. for treatment of PNH. However, many of thepatients treated with eculizumab remain anemic, and many patientscontinue to require blood transfusions. In addition, treatment witheculizumab requires life-long intravenous injections. Thus, there is anunmet need to develop novel inhibitors of the complement pathway.

Factor D is an attractive target for inhibition or regulation of thecomplement cascade due to its early and essential role in thealternative complement pathway, and its potential role in signalamplification within the classical and lectin complement pathways.Inhibition of factor D effectively interrupts the pathway and attenuatesthe formation of the membrane attack complex.

While initial attempts have been made to develop inhibitors of factor D,there are currently no small molecule factor D inhibitors in clinicaltrials. Examples of factor D inhibitors or prolyl compounds aredescribed in the following disclosures.

Biocryst Pharmaceuticals U.S. Pat. No. 6,653,340 titled “Compoundsuseful in the complement, coagulat and kallikrein pathways and methodfor their preparation” describes fused bicyclic ring compounds that arepotent inhibitors of factor D. Development of the factor D inhibitorBCX1470 was discontinued due to lack of specificity and short half-lifeof the compound.

Novartis PCT patent publication WO2012/093101 titled “Indole compoundsor analogues thereof useful for the treatment of age-related maculardegeneration” describes certain factor D inhibitors.

Novartis PCT patent publications WO2014/002057 titled “Pyrrolidinederivatives and their use as complement pathway modulators” andWO2014/009833 titled “Complement pathway modulators and uses thereof”describe additional factor D inhibitors with heterocyclic substituents.Additional factor D inhibitors are described in Novartis PCT patentpublications WO2014/002051, WO2014/002052, WO2014/002053, WO2014/002054,WO2014/002058, WO2014/002059, and WO2014/005150.

Bristol-Myers Squibb PCT patent publication WO2004/045518 titled “Openchain prolyl urea-related modulators of androgen receptor function”describes open chain prolyl urea and thiourea related compounds for thetreatment of androgen receptor-associated conditions, such asage-related diseases, for example, sarcopenia.

Japan Tobacco Inc. PCT patent publication WO1999/048492 titled “Amidederivatives and nociceptin antagonists” describes compounds with aproline-like core and aromatic substituents connected to the prolinecore through amide linkages useful for the treatment of pain.

Ferring B. V. and Yamanouchi Pharmaceutical Co. 1TD. PCT patentpublication WO1993/020099 titled “CCK and/or gastrin receptor ligands”describes compounds with a proline-like core and heterocyclicsubstituents connected to the proline core through amide linkages forthe treatment of, for example, gastric disorders or pain.

Alexion Pharmaceuticals PCT patent publication WO1995/029697 titled“Methods and compositions for the treatment of glomerulonephritis andother inflammatory diseases” discloses antibodies directed to C5 of thecomplement pathway for the treatment of glomerulonephritis andinflammatory conditions involving pathologic activation of thecomplement system. Alexion Pharmaceutical's anti-05 antibody eculizumab(Soliris®) is currently the only complement-specific antibody on themarket, and is the first and only approved treatment for paroxysmalnocturnal hemoglobinuria (PNH).

Compounds which mediate the complement pathway, and for example, act asfactor D inhibitors are needed for treatment of disorders in a host,including a human, associated with misregulation of the complementcascade.

SUMMARY

It has been discovered that a compound of Formula I, or apharmaceutically acceptable salt or composition thereof, wherein R¹² orR¹³ on the A group is an ether, is a superior inhibitor of complementfactor D.

In one embodiment, a method for the treatment of a disorder associatedwith a dysfunction, including increased activity, of the complementpathway is provided that includes the administration of an effectiveamount of a compound of Formula I, or a pharmaceutically acceptable saltthereof, optionally in a pharmaceutically acceptable carrier, asdescribed in more detail below.

In one embodiment, the disorder is associated with the alternativecomplement cascade pathway. In yet another embodiment, the disorder isassociated with the complement classical pathway. In a furtherembodiment, the disorder is associated with the complement lectinpathway. The factor D inhibitors provided herein can thus dampen orinhibit detrimental complement activity in a host, by administration ofan effective amount in a suitable manner to a host in need thereof.

Specific embodiments of this invention are directed to certain diseaseindications. In one embodiment, a method for the treatment of paroxysmalnocturnal hemoglobinuria (PNH) is provided that includes theadministration of an effective amount of a compound of Formula I, or apharmaceutically acceptable salt thereof, optionally in apharmaceutically acceptable carrier.

In another embodiment, a method for the treatment of age-related maculardegeneration (AMD) is provided that includes the administration of aneffective amount of a compound of Formula I, or a pharmaceuticallyacceptable salt thereof, optionally in a pharmaceutically acceptablecarrier. In another embodiment, a method for the treatment of rheumatoidarthritis is provided that includes the administration of an effectiveamount of a compound of Formula I, or a pharmaceutically acceptable saltthereof, optionally in a pharmaceutically acceptable carrier. In anotherembodiment, a method for the treatment of multiple sclerosis is providedthat includes the administration of an effective amount of a compound ofFormula I, or a pharmaceutically acceptable salt thereof, optionally ina pharmaceutically acceptable carrier.

In other embodiments of the invention, an active compound providedherein can be used to treat or prevent a disorder in a host mediated bycomplement factor D, or by an excessive or detrimental amount of the C3amplification loop of the complement pathway. As examples, the inventionincludes methods to treat or prevent complement associated disordersthat are induced by antibody-antigen interactions, a component of animmune or autoimmune disorder or by ischemic injury. The invention alsoprovides methods to decrease inflammation or an immune response,including an autoimmune response, where mediated or affected by factorD.

The disclosure provides compounds of Formula I

and the pharmaceutically acceptable salts and compositions thereof,wherein:

Q¹ is N(R¹) or C(R¹R^(1′));

Q² is C(R²R^(2′)), C(R²R^(2′))—C(R²R^(2′)), S, O, N(R²) or C(R²R^(2′))O;

Q³ is N(R³), S, or C(R³R^(3′));

X¹ and X² are independently N, CH, or CZ, or X¹ and X² together are C≡C;and

wherein Q¹, Q², Q³, X¹, and X² are selected such that a stable compoundresults.

Non-limiting examples of the

ring are illustrated below (any of which can be otherwise substitutedwith R¹, R^(1′), R², R^(2′), R³, and R^(3′)) as described in more detailbelow.

wherein q is 0, 1, 2 or 3 and r is 1, 2 or 3.

R and R′ are independently chosen from H, alkyl, cycloalkyl,cycloalkylalkyl, heterocycle, heterocycloalkyl, aryl, arylalkyl,heteroaryl, heteroarylalkyl wherein each group can be optionallysubstituted or any other substituent group herein that provides thedesired properties. In some embodiments, the ring includes one or morechiral carbon atoms. The invention includes embodiments in which thechiral carbon can be provided as an enantiomer, or mixtures ofenantiomers, including a racemic mixture. Where the ring includes morethan one stereocenter, all of the enantiomers and diastereomers areincluded in the invention as individual species.

Z is F, Cl, NH₂, CH₃, CH₂D, CHD₂, or CD₃.

R¹, R^(1′), R², R^(2′), R³, and R^(3′) are independently chosen at eachoccurrence, as appropriate, and only where a stable compound results,from hydrogen, halogen, hydroxyl, nitro, cyano, amino, C₁-C₆alkyl,C₂-C₆alkenyl, C₂-C₆alkynyl, C₁-C₆alkoxy, C₂-C₆alkynyl, C₂-C₆alkanoyl,C₁-C₆thioalkyl, hydroxyC₁-C₆alkyl, aminoC₁-C₆alkyl, —C₀-C₄alkylNR⁹R¹⁰,—C(O)OR⁹, —OC(O)R⁹, —NR⁹C(O)R¹⁰, —C(O)NR⁹R¹⁰, —OC(O)NR⁹R¹⁰,—NR⁹C(O)OR¹⁰, C₁-C₂haloalkyl, and C₁-C₂haloalkoxy, where R⁹ and R¹⁰ areindependently chosen at each occurrence from hydrogen, C₁-C₆alkyl,(C₃-C₇cycloalkyl)C₀-C₄alkyl, —C₀-C₄alkyl(C₃-C₇cycloalkyl), and—O—C₀-C₄alkyl(C₃-C₇cycloalkyl).

In alternative embodiments, R¹ and R^(1′) or R³ and R^(3′) may be takentogether to form a 3- to 6-membered carbocyclic spiro ring or a 3- to6-membered heterocyclic spiro ring containing 1 or 2 heteroatomsindependently chosen from N, O, or S; R² and R^(2′) may be takentogether to form a 3- to 6-membered carbocyclic spiro ring; or R² andR^(2′) may be taken together to form a 3- to 6-membered heterocyclicspiro ring; each of which spiro ring each of which ring may beunsubstituted or substituted with 1 or more substituents independentlychosen from halogen (and in particular F), hydroxyl, cyano, —COOH,C₁-C₄alkyl (including in particular methyl), C₂-C₄alkenyl, C₂-C₄alkynyl,C₁-C₄alkoxy, C₂-C₄alkanoyl, hydroxyC₁-C₄alkyl, (mono- anddi-C₁-C₄alkylamino)C₀-C₄alkyl, —C₀-C₄alkyl(C₃-C₇cycloalkyl),—O—C₀-C₄alkyl(C₃-C₇cycloalkyl), C₁-C₂haloalkyl, and C₁-C₂haloalkoxy.

In alternative embodiments, R¹ and R² may be taken together to form a3-membered carbocyclic ring; R¹ and R² may be taken together to form a4- to 6-membered carbocyclic or aryl ring or a 4- to 6-memberedheterocyclic or heteroaryl ring containing 1 or 2 heteroatomsindependently chosen from N, O, and S; or R² and R³, if bound toadjacent carbon atoms, may be taken together to form a 3- to 6-memberedcarbocyclic or aryl ring or a 3- to 6-membered heterocyclic orheteroaryl ring; each of which ring may be unsubstituted or substitutedwith 1 or more substituents independently chosen from halogen (and inparticular F), hydroxyl, cyano, —COOH, C₁-C₄alkyl (including inparticular methyl), C₂-C₄alkenyl, C₂-C₄alkynyl, C₁-C₄alkoxy,C₂-C₄alkanoyl, hydroxyC₁-C₄alkyl, (mono- anddi-C₁-C₄alkylamino)C₀-C₄alkyl, —C₀-C₄alkyl(C₃-C₇cycloalkyl),—O—C₀-C₄alkyl(C₃-C₇cycloalkyl), C₁-C₂haloalkyl, and C₁-C₂haloalkoxy.

In alternative embodiments, R¹ and R^(1′), R² and R^(2′), or R³ andR^(3′) can be taken together to form a carbonyl group. In alternativeembodiments, R¹ and R² or R^(2′) and R³ can be taken together to form acarbon-carbon double bond.

A is a group chosen from:

R⁴ is chosen from —CHO, —CONH₂, C₂-C₆alkanoyl, hydrogen, —SO₂NH₂,—C(CH₂)₂F, —CH(CF₃)NH₂, C₁-C₆alkyl, —C₀-C₄alkyl(C₃-C₇cycloalkyl),—C(O)C₀-C₂alkyl(C₃-C₇cycloalkyl),

each of which R⁴ other than hydrogen, —CHO, and —CONH₂, is unsubstitutedor substituted with one or more of amino, imino, halogen, hydroxyl,cyano, cyanoimino, C₁-C₂alkyl, C₁-C₂alkoxy, —C₀-C₂alkyl(mono- anddi-C₁-C₄alkylamino), C₁-C₂haloalkyl, and C₁-C₂haloalkoxy.

R⁵ and R⁶ are independently chosen from —CHO, —C(O)NH₂, —C(O)NH(CH₃),C₂-C₆alkanoyl, hydrogen, hydroxyl, halogen, cyano, nitro, —COOH,—SO₂NH₂, vinyl, C₁-C₆alkyl (including methyl), C₂-C₆alkenyl,C₁-C₆alkoxy, —C₀-C₄alkyl(C₃-C₇cycloalkyl),—C(O)C₀-C₄alkyl(C₃-C₇cycloalkyl), —P(O)(OR⁹)₂, —OC(O)R⁹, —C(O)OR⁹,—C(O)N(CH₂CH₂R⁹)(R¹⁰), —NR⁹C(O)R¹⁰, phenyl, or 5- to 6-memberedheteroaryl.

Each R⁵ and R⁶ other than hydrogen, hydroxyl, cyano, and —COOH isunsubstituted or optionally substituted. For example, R⁵ and R⁶ otherthan hydrogen, hydroxyl, cyano, and —COOH may be substituted with one ormore substituents independently chosen from halogen, hydroxyl, amino,imino, cyano, cyanoimino, C₁-C₂alkyl, C₁-C₄alkoxy, —C₀-C₂alkyl(mono- anddi-C₁-C₄alkylamino), C₁-C₂haloalkyl, and C₁-C₂haloalkoxy.

R^(6′) is hydrogen, halogen, hydroxyl, C₁-C₄alkyl,—C₀-C₄alkyl(C₃-C₇cycloalkyl), or C₁-C₄alkoxy; or R⁶ and R^(6′) may betaken together to form an oxo, vinyl, or imino group.

R⁷ is hydrogen, C₁-C₆alkyl, or —C₀-C₄alkyl(C₃-C₇cycloalkyl).

R⁸ and R^(8′) are independently chosen from hydrogen, halogen, hydroxyl,C₁-C₆alkyl, —C₀-C₄alkyl(C₃-C₇cycloalkyl), C₁-C₆alkoxy, and(C₁-C₄alkylamino)C₀-C₂alkyl; or R⁸ and R^(8′) are taken together to forman oxo group; or R⁸ and R^(8′) can be taken together with the carbonthat they are bonded to form a 3-membered carbocyclic ring.

R¹⁶ is absent or may include one or more substituents independentlychosen from halogen, hydroxyl, nitro, cyano, C₁-C₆alkyl, C₂-C₆alkenyl,C₂-C₆alkanoyl, C₁-C₆alkoxy, —C₀-C₄alkyl(mono- and di-C₁-C₆alkylamino),—C₀-C₄alkyl(C₃-C₇cycloalkyl), C₁-C₂haloalkyl, and C₁-C₂haloalkoxy.

R¹⁹ is hydrogen, C₁-C₆alkyl, C₂-C₆alkenyl, C₂-C₆alkanoyl,—SO₂C₁-C₆alkyl, (mono- and di-C₁-C₆alkylamino)C₁-C₄alkyl,—C₀-C₄alkyl(C₃-C₇cycloalkyl), —C₀-C₄alkyl(C₃-C₇heterocycloalkyl),—C₀-C₄alkyl(aryl), C₀-C₄alkyl(heteroaryl), and wherein R¹⁹ other thanhydrogen is unsubstituted or substituted with one or more substituentsindependently chosen from halogen, hydroxyl, amino, —COOH, and—C(O)OC₁-C₄alkyl.

X¹¹ is N or CR¹¹.

X¹² is N or CR¹².

X¹³ is N or CR¹³.

X¹⁴ is N or CR¹⁴.

No more than 2 of X¹¹, X¹², X¹³, and X¹⁴ are N.

One of R¹² and R¹³ is chosen from R³¹ and the other of R¹² and R¹³ ischosen from R³²:

R³¹ is chosen from hydrogen, halogen, hydroxyl, nitro, cyano, amino,—COOH, C₁-C₂haloalkyl, C₁-C₂haloalkoxy, C₁-C₆alkyl,—C₀-C₄alkyl(C₃-C₇cycloalkyl), C₂-C₆alkenyl, C₂-C₆alkanoyl, C₁-C₆alkoxy,C₂-C₆alkenyloxy, —C(O)OR⁹, C₁-C₆thioalkyl, —C₀-C₄alkylNR⁹R¹⁰,—C(O)NR⁹R¹⁰, —SO₂R⁹, —SO₂NR⁹R¹⁰, —OC(O)R⁹, and —C(NR⁹)NR⁹R¹⁰, each ofwhich R³¹ other than hydrogen, halogen, hydroxyl, nitro, cyano,C₁-C₂haloalkyl, and C₁-C₂haloalkoxy is unsubstituted or substituted withone or more substituents independently selected from halogen, hydroxyl,nitro, cyano, amino, —COOH, —CONH₂ C₁-C₂haloalkyl, and C₁-C₂haloalkoxy,and each of which R³¹ is also optionally substituted with onesubstituent chosen from phenyl and 4- to 7-membered heterocyclecontaining 1, 2, or 3 heteroatoms independently chosen from N, O, and S;which phenyl or 4- to 7-membered heterocycle is unsubstituted orsubstituted with one or more substituents independently chosen fromhalogen, hydroxyl, nitro, cyano, C₁-C₆alkyl, C₂-C₆alkenyl,C₂-C₆alkanoyl, C₁-C₆alkoxy, (mono- and di-C₁-C₆alkylamino)C₀-C₄alkyl,C₁-C₆alkylester, —C₀-C₄alkyl)(C₃-C₇cycloalkyl), C₁-C₂haloalkyl, andC₁-C₂haloalkoxy;

R³² is chosen from —O(CH₂)₁₋₄R^(23a), —OC₂-C₄alkenylR^(23a),—OC₂-C₄alkynylR²³, —O(CH₂)₁₋₄ paracyclophane,—O(CH₂)₁₋₄P(O)R^(23b)R^(23b), —O(CH₂)₁₋₄S(O)NR²¹R²²,—O(CH₂)₁₋₄S(O)NR²⁴R²⁵, —O(CH₂)₁₋₄SO₂NR²¹R²², —O(CH₂)₁₋₄SO₂NR²⁴R²⁵,—O(C₃-C₇cycloalkyl), —O(aryl), —O(heteroaryl), and —O(heterocycle) andeach group can be optionally substituted as further described herein.

R¹¹, R¹⁴, and R¹⁵ are independently chosen at each occurrence fromhydrogen, halogen, hydroxyl, nitro, cyano, —O(PO)(OR⁹)₂, —(PO)(OR⁹)₂,C₁-C₆alkyl, C₂-C₆alkenyl, C₂-C₆alkynyl, C₂-C₆alkenyl(aryl),C₂-C₆alkenyl(cycloalkyl), C₂-C₆alkenyl(heterocycle),C₂-C₆alkenyl(heteroaryl), C₂-C₆alkynyl, C₂-C₆alkynyl(aryl),C₂-C₆alkynyl(cycloalkyl), C₂-C₆alkynyl(heterocycle),C₂-C₆alkynyl(heteroaryl), C₂-C₆alkanoyl, C₁-C₆alkoxy, C₁-C₆thioalkyl,—C₀-C₄alkyl(mono- and di-C₁-C₆alkylamino), —C₀-C₄alkyl(C₃-C₇cycloalkyl),—C₀-C₄alkoxy(C₃-C₇cycloalkyl), C₁-C₂haloalkyl, and C₁-C₂haloalkoxy.

In an alternative embodiment, R¹² and R¹³ are each independentlyselected from an R³² moiety.

R²¹ and R²² are independently chosen at each occurrence from hydrogen,hydroxyl, cyano, amino, C₁-C₆alkyl, C₁-C₆haloalkyl, C₁-C₆alkoxy,(C₃-C₇cycloalkyl)C₀-C₄alkyl, (phenyl)C₀-C₄alkyl,—C₁-C₄alkylOC(O)OC₁-C₆alkyl, —C₁-C₄alkylOC(O)C₁-C₆alkyl,—C₁-C₄alkylC(O)OC₁-C₆alkyl, (4- to 7-memberedheterocycloalkyl)C₀-C₄alkyl having 1, 2, or 3 heteroatoms independentlychosen from N, O, and S, and (5- or 6-membered unsaturated or aromaticheterocycle)C₀-C₄alkyl having 1, 2, or 3 heteroatoms independentlychosen from N, O, and S, and each R²¹ and R²² can be optionallysubstituted.

R²³ is independently chosen at each occurrence from C₁-C₆alkyl,C₁-C₆haloalkyl, (aryl)C₀-C₄alkyl, (C₃-C₇cycloalkyl)C₀-C₄alkyl,(phenyl)C₀-C₄alkyl, (4- to 7-membered heterocycloalkyl)C₀-C₄alkyl having1, 2, or 3 heteroatoms independently chosen from N, O, and S, and (5- or6-membered unsaturated or aromatic heterocycle)C₀-C₄alkyl having 1, 2,or 3 heteroatoms independently chosen from N, O, and S, and each R²³ canbe optionally substituted.

R^(23a) is independently chosen at each occurrence from(C₃-C₇cycloalkyl), and each R^(23a) can be optionally substituted.

R^(23b) is independently chosen at each occurrence from hydroxyl,C₁-C₆alkoxy, C₁-C₆alkyl, (C₃-C₇cycloalkyl)C₀-C₄alkyl,(phenyl)C₀-C₄alkyl, —O(CH₂)₂₋₄O(CH₂)₈₋₁₈, —OC(R^(23c))₂OC(O)OR^(23d),—OC(R^(23c))₂OC(O)R^(23d), an N-linked amino acid or an N-linked aminoacid ester, and each R^(23b) can be optionally substituted.

R^(23c) is independently chosen at each occurrence from hydrogen,C₁-C₈alkyl, C₂-C₈alkenyl, C₂-C₈alkynyl, (aryl)C₀-C₄alkyl,(aryl)C₂-C₈alkenyl- or (aryl)C₂-C₈alkynyl; or two R^(23c) groups can betaken together with the carbon that they are bonded to form a 3-6membered heterocycloalkyl having 1, 2, or 3 heteroatoms independentlychosen from N, O, and S, or a 3-6 membered carbocyclic ring, and eachR^(23c) can be optionally substituted.

R^(23d) is independently chosen at each occurrence from C₁-C₈alkyl,C₂-C₈alkenyl, C₂-C₈alkynyl, (aryl)C₀-C₄alkyl, (aryl)C₂-C₈alkenyl or(aryl)C₂-C₈alkynyl, and each R^(23d) can be optionally substituted.

R²⁴ and R²⁵ are taken together with the nitrogen to which they areattached to form a 4- to 7-membered monocyclic heterocycloalkyl group,or a 6- to 10-membered bicyclic heterocyclic group having fused, spiro,or bridged rings, and each R²⁴ and R²⁵ can be optionally substituted.

L is a bond or is chosen from the formulas

where R¹⁷ is hydrogen, C₁-C₆alkyl, or —C₀-C₄alkyl(C₃-C₇cycloalkyl) andR¹⁸ and R^(18′) are independently chosen from hydrogen, halogen,hydroxymethyl, and methyl; and m is 0, 1, 2, or 3.

B is a monocyclic or bicyclic carbocyclic; a monocyclic or bicycliccarbocyclic-oxy group; a monocyclic, bicyclic, or tricyclic heterocyclicgroup having 1, 2, 3, or 4 heteroatoms independently selected from N, O,and S and from 4 to 7 ring atoms per ring; C₂-C₆alkenyl; C₂-C₆alkynyl;—(C₀-C₄alkyl)(aryl); —(C₀-C₄alkyl)(heteroaryl); or—(C₀-C₄alkyl)(biphenyl).

Each of which B is unsubstituted or substituted with one or moresubstituents independently chosen from R³³ and R³⁴, and 0 or 1substituents chosen from R³⁵ and R³⁶.

R³³ is independently chosen from halogen, hydroxyl, —COOH, cyano,C₁-C₆alkyl, C₂-C₆alkanoyl, C₁-C₆alkoxy, —C₀-C₄alkylNR⁹R¹⁰, —SO₂R⁹,C₁-C₂haloalkyl, and C₁-C₂haloalkoxy.

R³⁴ is independently chosen from nitro, C₂-C₆alkenyl, C₂-C₆alkynyl,C₁-C₆thioalkyl, -JC₃-C₇cycloalkyl, —B(OH)₂, -JC(O)NR⁹R²³, -JOSO₂OR²¹,—C(O)(CH₂)₁₋₄S(O)R²¹, —O(CH₂)₁₋₄S(O)NR²¹R²², -JOP(O)(OR²¹)(OR²²),-JP(O)(OR²¹)(OR²²), -JOP(O)(OR²¹)R²², -JP(O)(OR²¹)R²², -JOP(O)R²¹R²²,-JP(O)R²¹R²², -JSP(O)(OR²¹)(OR²²), -JSP(O)(OR²¹)(R²²),-JSP(O)(R²¹)(R²²), -JNR⁹P(O)(NHR²¹)(NHR²²), -JNR⁹P(O)(OR²¹)(NHR²²),-JNR⁹P(O)(OR²¹)(OR²²), -JC(S)R²¹, -JNR²¹SO₂R²², -JNR⁹S(O)NR¹⁰R²²,-JNR⁹SO₂NR¹⁰R²², -JSO₂NR⁹COR²², -JSO₂NR⁹CONR²¹R²², -JNR²¹SO₂R²²,-JC(O)NR²¹SO₂R²², -JC(NH₂)NR²², -JC(NH₂)NR⁹S(O)₂R²², -JOC(O)NR²¹R²²,JNR²¹C(O)OR²², -JNR²¹OC(O)R²², —(CH₂)₁₋₄C(O)NR²¹R²², -JC(O)R²⁴R²⁵,-JNR⁹C(O)R²¹, -JC(O)R²¹, -JNR⁹C(O)NR¹⁰R²², —CCR²¹, —(CH₂)₁₋₄OC(O)R²¹,and -JC(O)OR²³; each of which R³⁴ may be unsubstituted or substitutedwith one or more substituents independently chosen from halogen,hydroxyl, nitro, cyano, amino, oxo, —B(OH)₂, —Si(CH₃)₃, —COOH, —CONH₂,—P(O)(OH)₂, C₁-C₆alkyl, —C₀-C₄alkyl(C₃-C₇cycloalkyl), C₁-C₆alkoxy,—C₀-C₂alkyl(mono- and di-C₁-C₄alkylamino), C₁-C₆alkylester,C₁-C₄alkylamino, C₁-C₄hydroxylalkyl, C₁-C₂haloalkyl, andC₁-C₂haloalkoxy.

R³⁵ is independently chosen from naphthyl, naphthyloxy, indanyl, (4- to7-membered heterocycloalkyl)C₀-C₄alkyl containing 1 or 2 heteroatomschosen from N, O, and S, and bicyclic heterocycle containing 1, 2, or 3heteroatoms independently chosen from N, O, and S, and containing 4- to7-ring atoms in each ring; each of which R³⁵ is unsubstituted orsubstituted with one or more substituents independently chosen fromhalogen, hydroxyl, nitro, cyano, C₁-C₆alkyl, C₂-C₆alkenyl,C₂-C₆alkanoyl, C₁-C₆alkoxy, (mono- and di-C₁-C₆alkylamino)C₀-C₄alkyl,C₁-C₆alkylester, —C₀-C₄alkyl(C₃-C₇cycloalkyl), —SO₂R⁹, C₁-C₂haloalkyl,and C₁-C₂haloalkoxy.

R³⁶ is independently chosen from tetrazolyl, (phenyl)C₀-C₂alkyl,(phenyl)C₁-C₂alkoxy, phenoxy, and 5- or 6-membered heteroaryl containing1, 2, or 3 heteroatoms independently chosen from N, O, B, and S, each ofwhich R³⁶ is unsubstituted or substituted with one or more substituentsindependently chosen from halogen, hydroxyl, nitro, cyano, C₁-C₆alkyl,C₂-C₆alkenyl, C₂-C₆alkanoyl, C₁-C₆alkoxy, (mono- anddi-C₁-C₆alkylamino)C₀-C₄alkyl, C₁-C₆alkylester,—C₀-C₄alkyl(C₃-C₇cycloalkyl), —SO₂R⁹, —OSi(CH₃)₂C(CH₃)₃,—Si(CH₃)₂C(CH₃)₃, C₁-C₂haloalkyl, and C₁-C₂haloalkoxy.

J is independently chosen at each occurrence from a covalent bond,C₁-C₄alkylene, —OC₁-C₄alkylene, C₂-C₄alkenylene, and C₂-C₄alkynylene.

Pharmaceutical compositions comprising a compound or salt of Formula Itogether with a pharmaceutically acceptable carrier are also disclosed.

Methods of treating or preventing disorders mediated by complementcascade factor D, including but not limited to age-related maculardegeneration (AMD), retinal degeneration, other ophthalmic diseases(e.g., geographic atrophy), paroxysymal nocturnal hemoglobinuria (PNH),multiple sclerosis (MS), arthritis including rheumatoid arthritis (RA),a respiratory disease or a cardiovascular disease, are provided,comprising administering a therapeutically effective amount of acompound or salt of Formula I to a host, including a human, in need ofsuch treatment are also disclosed.

In another embodiment, an effective amount of an active factor Dinhibiting compound is provided to treat an inflammatory or immunedisorder, including an autoimmune disorder, that is mediated or affectedby factor D. In an alternative embodiment, the compound of Formula I canbe used to treat a disorder mediated by the complement pathway,regardless whether it is acting through Factor D.

The present invention includes at least the following features:

(a) a compound of Formula I as described herein, and pharmaceuticallyacceptable salts and prodrugs thereof (each of which and all subgenusesand species thereof considered individually and specifically described);

(b) Formula I as described herein, and pharmaceutically acceptable saltsand prodrugs thereof, for use in treating or preventing disordersmediated by the complement pathway, and for example, cascade factor D,including age-related macular degeneration (AMD), retinal degeneration,paroxysymal nocturnal hemoglobinuria (PNH), multiple sclerosis (MS), andrheumatoid arthritis (RA) and other disorders described further herein;

(c) use of Formula I, and pharmaceutically acceptable salts and prodrugsthereof in the manufacture of a medicament for use in treating orpreventing disorders mediated by complement cascade factor D, includingage-related macular degeneration (AMD), retinal degeneration,paroxysymal nocturnal hemoglobinuria (PNH), multiple sclerosis (MS), andrheumatoid arthritis (RA) and other disorders described further herein;

(d) a process for manufacturing a medicament intended for thetherapeutic use for treating or preventing treating or preventingdisorders mediated by complement cascade factor D, including age-relatedmacular degeneration (AMD), retinal degeneration, paroxysymal nocturnalhemoglobinuria (PNH), multiple sclerosis (MS), and rheumatoid arthritis(RA) and other disorders described further herein characterized in thatFormula I as described herein is used in the manufacture;

(e) a pharmaceutical formulation comprising an effective host-treatingamount of the Formula I or a pharmaceutically acceptable salt or prodrugthereof together with a pharmaceutically acceptable carrier or diluent;

(f) Formula I as described herein in substantially pure form, includingsubstantially isolated from other chemical entities (e.g., at least 90or 95%);

(g) processes for the manufacture of the compounds of Formula I andsalts, compositions, dosage forms thereof; and

(h) processes for the preparation of therapeutic products that containan effective amount of Formula I, as described herein.

DETAILED DESCRIPTION I. Terminology

Compounds are described using standard nomenclature. Unless definedotherwise, all technical and scientific terms used herein have the samemeaning as is commonly understood by one of skill in the art to whichthis invention belongs.

The compounds in any of the Formulas described herein includeenantiomers, mixtures of enantiomers, diastereomers, tautomers,racemates and other isomers, such as rotamers, as if each isspecifically described. “Formula I” includes all subgeneric groups ofFormula I, such as Formula IA and Formula IB and also includespharmaceutically acceptable salts of a compound of Formula I, unlessclearly contraindicated by the context in which this phrase is used.“Formula I” also includes all subgeneric groups of Formula I, such asFormulas IC-ID, and Formulas II-XXX, and also includes pharmaceuticallyacceptable salts of all subgeneric groups of Formula I, such as FormulasIA-ID, and Formulas II-XXX, unless contraindicated by the context inwhich this phrase is used.

The terms “a” and “an” do not denote a limitation of quantity, butrather denote the presence of at least one of the referenced item. Theterm “or” means “and/or”. Recitation of ranges of values are merelyintended to serve as a shorthand method of referring individually toeach separate value falling within the range, unless otherwise indicatedherein, and each separate value is incorporated into the specificationas if it were individually recited herein. The endpoints of all rangesare included within the range and independently combinable. All methodsdescribed herein can be performed in a suitable order unless otherwiseindicated herein or otherwise clearly contradicted by context. The useof examples, or exemplary language (e.g., “such as”), is intended merelyto better illustrate the invention and does not pose a limitation on thescope of the invention unless otherwise claimed. Unless definedotherwise, technical and scientific terms used herein have the samemeaning as is commonly understood by one of skill in the art to whichthis invention belongs.

The present invention includes compounds of Formula I and the use ofcompounds with at least one desired isotopic substitution of an atom, atan amount above the natural abundance of the isotope, i.e., enriched.Isotopes are atoms having the same atomic number but different massnumbers, i.e., the same number of protons but a different number ofneutrons.

Examples of isotopes that can be incorporated into compounds of theinvention include isotopes of hydrogen, carbon, nitrogen, oxygen,phosphorous, fluorine, and chlorine, such as ²H, ³H, ¹¹C, ¹³C, ¹⁴C, ¹⁵N,¹⁸F, ³¹P, ³²P, ³⁵S, ³⁶CI, ¹²⁵I respectively. The invention includesisotopically modified compounds of Formula I. In one embodiment,isotopically labelled compounds can be used in metabolic studies (with¹⁴C), reaction kinetic studies (with, for example ²H or ³H), detectionor imaging techniques, such as positron emission tomography (PET) orsingle-photon emission computed tomography (SPECT) including drug orsubstrate tissue distribution assays, or in radioactive treatment ofpatients. In particular, an ¹⁸F labeled compound may be particularlydesirable for PET or SPECT studies. Isotopically labeled compounds ofthis invention and prodrugs thereof can generally be prepared bycarrying out the procedures disclosed in the schemes or in the examplesand preparations described below by substituting a readily availableisotopically labeled reagent for a non-isotopically labeled reagent.

By way of general example and without limitation, isotopes of hydrogen,for example, deuterium (²H) and tritium (³H) may be used anywhere indescribed structures that achieves the desired result. Alternatively orin addition, isotopes of carbon, e.g., ¹³C and ¹⁴C, may be used. In oneembodiment, the isotopic substitution is deuterium for hydrogen at oneor more locations on the molecule to improve the performance of thedrug, for example, the pharmacodynamics, pharmacokinetics,biodistribution, half-life, stability, AUC, Tmax, Cmax, etc. Forexample, the deuterium can be bound to carbon in a location of bondbreakage during metabolism (an α-deuterium kinetic isotope effect) ornext to or near the site of bond breakage (a β-deuterium kinetic isotopeeffect).

Isotopic substitutions, for example deuterium substitutions, can bepartial or complete. Partial deuterium substitution means that at leastone hydrogen is substituted with deuterium. In certain embodiments, theisotope is 90, 95 or 99% or more enriched in an isotope at any locationof interest. In one embodiments deuterium is 90, 95 or 99% enriched at adesired location. Unless otherwise stated, the enrichment at any pointis above natural abundance and enough to alter a detectable property ofthe drug in a human.

In one embodiment, the substitution of a hydrogen atom for a deuteriumatom occurs within an R group substituent on the L-α moiety region. Inone embodiment, the substitution of a hydrogen atom for a deuterium atomoccurs within an R group selected from any of R¹⁸, R^(18′), R³³, R³⁴,R³⁵, and/or R³⁶. In one embodiment, the substitution of a hydrogen atomfor a deuterium atom occurs within an R group substituent within theA-carbonyl moiety region. In one embodiment, the substitution of ahydrogen atom for a deuterium atom occurs at R⁴, R⁵, R⁶, R^(6′), R⁷, R⁸,R^(8′), R¹¹, R¹², R¹³, R¹⁴, R¹⁵, R¹⁶, R¹⁹, R²¹, R²², R²³, R^(23a),R^(23b), R^(23c), R^(23d), R³¹, and R³². In other embodiments, certainsubstituents on the proline ring are selectively deuterated. Forexample, in one embodiment, the substitution of a hydrogen atom for adeuterium atom occurs at R, R′, R¹, R^(1′), R², R^(2′), R³, and/orR^(3′). In one embodiment, for example, when any of the R substituentsof the proline ring are methyl or methoxy, the alkyl residue isoptionally deuterated, e.g., CD₃ or OCD3. In certain other embodiments,when two substituents of the proline ring are combined to form acyclopropyl ring, the unsubstituted methylene carbon is deuterated.

The substitution of a hydrogen atom for a deuterium atom occurs withinan R group when at least one of the variables within the R group ishydrogen (e.g., ²H or D) or alkyl (e.g., CD₃). For example, when any ofR groups are, or contain for example through substitution, methyl orethyl, the alkyl residue is typically deuterated, e.g., CD₃, CH₂CD₃ orCD₂CD₃.

The compound of the present invention may form a solvate with solvents(including water). Therefore, in one embodiment, the invention includesa solvated form of the active compound. The term “solvate” refers to amolecular complex of a compound of the present invention (includingsalts thereof) with one or more solvent molecules. Examples of solventsare water, ethanol, dimethyl sulfoxide, acetone and other common organicsolvents. The term “hydrate” refers to a molecular complex comprising acompound of the invention and water. Pharmaceutically acceptablesolvates in accordance with the invention include those wherein thesolvent of crystallization may be isotopically substituted, e.g. D₂O,d₆-acetone, d₆-DMSO. A solvate can be in a liquid or solid form.

A dash (“-”) that is not between two letters or symbols is used toindicate a point of attachment for a substituent. For example, —(C═O)NH₂is attached through carbon of the keto (C═O) group.

The term “substituted”, as used herein, means that any one or morehydrogens on the designated atom or group is replaced with a moietyselected from the indicated group, provided that the designated atom'snormal valence is not exceeded. For example, when the substituent is oxo(i.e., ═O) then two hydrogens on the atom are replaced. When an oxogroup replaces two hydrogens in an aromatic moiety, the correspondingpartially unsaturated ring replaces the aromatic ring. For example apyridyl group substituted by oxo is a pyridone. Combinations ofsubstituents and/or variables are permissible only if such combinationsresult in stable compounds or useful synthetic intermediates.

A stable compound or stable structure refers to a compound leading to acompound that can be isolated and can be formulated into a dosage formwith a shelf life of at least one month.

Any suitable group may be present on a “substituted” or “optionallysubstituted” position that forms a stable molecule and advances thedesired purpose of the invention and includes, but is not limited to,e.g., halogen (which can independently be F, Cl, Br or I); cyano;hydroxyl; nitro; azido; alkanoyl (such as a C₂-C₆ alkanoyl group);carboxamide; alkyl, cycloalkyl, alkenyl, alkynyl, alkoxy, aryloxy suchas phenoxy; alkylthio including those having one or more thioetherlinkages; alkylsulfinyl; alkylsulfonyl groups including those having oneor more sulfonyl linkages; aminoalkyl groups including groups having oneor more N atoms; aryl (e.g., phenyl, biphenyl, naphthyl, or the like,each ring either substituted or unsubstituted aromatic); arylalkylhaving for example, 1 to 3 separate or fused rings and from 6 to about14 or 18 ring carbon atoms, with benzyl being an exemplary arylalkylgroup; arylalkoxy, for example, having 1 to 3 separate or fused ringswith benzyloxy being an exemplary arylalkoxy group; or a saturated,unsaturated, or aromatic heterocyclic group having 1 to 3 separate orfused rings with one or more N, O or S atoms, e.g. coumarinyl,quinolinyl, isoquinolinyl, quinazolinyl, pyridyl, pyrazinyl,pyrimidinyl, furanyl, pyrrolyl, thienyl, thiazolyl, triazinyl, oxazolyl,isoxazolyl, imidazolyl, indolyl, benzofuranyl, benzothiazolyl,tetrahydrofuranyl, tetrahydropyranyl, piperidinyl, morpholinyl,piperazinyl, and pyrrolidinyl. Such heterocyclic groups may be furthersubstituted, e.g. with hydroxy, alkyl, alkoxy, halogen and amino. Incertain embodiments “optionally substituted” includes one or moresubstituents independently chosen from halogen, hydroxyl, amino, cyano,—CHO, —COOH, —CONH₂, C₁-C₆alkyl, C₂-C₆alkenyl, C₂-C₆alkynyl,—C₁-C₆alkoxy, C₂-C₆alkanoyl, C₁-C₆alkylester, (mono- anddi-C₁-C₆alkylamino)C₀-C₆alkyl, C₁-C₂haloalkyl, hydoxyC₁-C₆alkyl, ester,carbamate, urea, sulfonamide, —C₁-C₆alkyl(heterocyclo),C₁-C₆alkyl(heteroaryl), —C₁-C₆alkyl(C₃-C₇cycloalkyl),O—C₁-C₆alkyl(C₃-C₇cycloalkyl), B(OH)₂, phosphate, phosphonate andC₁-C₂haloalkoxy.

“Alkyl” is a branched or straight chain saturated aliphatic hydrocarbongroup. In one embodiment, the alkyl contains from 1 to about 18 carbonatoms, more generally from 1 to about 6 carbon atoms or from 1 to about4 carbon atoms. In one embodiment, the alkyl contains from 1 to about 8carbon atoms. In certain embodiments, the alkyl is C₁-C₂, C₁-C₃, orC₁-C₆. The specified ranges as used herein indicate an alkyl grouphaving each member of the range described as an independent species. Forexample, the term C₁-C₆ alkyl as used herein indicates a straight orbranched alkyl group having from 1, 2, 3, 4, 5, or 6 carbon atoms and isintended to mean that each of these is described as an independentspecies. For example, the term C₁-C₆alkyl as used herein indicates astraight or branched alkyl group having from 1, 2, 3, or 4 carbon atomsand is intended to mean that each of these is described as anindependent species. When C₀-C_(n) alkyl is used herein in conjunctionwith another group, for example, (C₃-C₇cycloalkyl)C₀-C₄ alkyl, or—C₀-C₄alkyl(C₃-C₇cycloalkyl), the indicated group, in this casecycloalkyl, is either directly bound by a single covalent bond(C₀alkyl), or attached by an alkyl chain in this case 1, 2, 3, or 4carbon atoms. Alkyls can also be attached via other groups such asheteroatoms as in —O—C₀-C₄alkyl(C₃-C₇cycloalkyl). Examples of alkylinclude, but are not limited to, methyl, ethyl, n-propyl, isopropyl,n-butyl, isobutyl, sec-butyl, t-butyl, n-pentyl, isopentyl, tert-pentyl,neopentyl, n-hexyl, 2-methylpentane, 3-methylpentane, 2,2-dimethylbutaneand 2,3-dimethylbutane. In one embodiment, the alkyl group is optionallysubstituted as described above.

“Alkenyl” is a branched or straight chain aliphatic hydrocarbon grouphaving one or more carbon-carbon double bonds that may occur at a stablepoint along the chain. Nonlimiting examples are C₂-C₈alkenyl,C₂-C₆alkenyl and C₂-C₄alkenyl. The specified ranges as used hereinindicate an alkenyl group having each member of the range described asan independent species, as described above for the alkyl moiety.Examples of alkenyl include, but are not limited to, ethenyl andpropenyl. In one embodiment, the alkenyl group is optionally substitutedas described above.

“Alkynyl” is a branched or straight chain aliphatic hydrocarbon grouphaving one or more carbon-carbon triple bonds that may occur at anystable point along the chain, for example, C₂-C₈alkynyl or C₂-C₆alkynyl.The specified ranges as used herein indicate an alkynyl group havingeach member of the range described as an independent species, asdescribed above for the alkyl moiety. Examples of alkynyl include, butare not limited to, ethynyl, propynyl, 1-butynyl, 2-butynyl, 3-butynyl,1-pentynyl, 2-pentynyl, 3-pentynyl, 4-pentynyl, 1-hexynyl, 2-hexynyl,3-hexynyl, 4-hexynyl and 5-hexynyl. In one embodiment, the alkynyl groupis optionally substituted as described above.

“Alkylene” is a bivalent saturated hydrocarbon. Alkylenes, for example,can be a 1 to 8 carbon moiety, 1 to 6 carbon moiety, or an indicatednumber of carbon atoms, for example C₁-C₄alkylene, C₁-C₃alkylene, orC₁-C₂alkylene.

“Alkenylene” is a bivalent hydrocarbon having at least one carbon-carbondouble bond. Alkenylenes, for example, can be a 2 to 8 carbon moiety, 2to 6 carbon moiety, or an indicated number of carbon atoms, for exampleC₂-C₄alkenylene.

“Alkynylene” is a bivalent hydrocarbon having at least one carbon-carbontriple bond. Alkynylenes, for example, can be a 2 to 8 carbon moiety, 2to 6 carbon moiety, or an indicated number of carbon atoms, for exampleC₂-C₄alkynylene.

“Alkoxy” is an alkyl group as defined above covalently bound through anoxygen bridge (—O—). Examples of alkoxy include, but are not limited to,methoxy, ethoxy, n-propoxy, i-propoxy, n-butoxy, 2-butoxy, t-butoxy,n-pentoxy, 2-pentoxy, 3-pentoxy, isopentoxy, neopentoxy, n-hexoxy,2-hexoxy, 3-hexoxy, and 3-methylpentoxy. Similarly an “alkylthio” or a“thioalkyl” group is an alkyl group as defined above with the indicatednumber of carbon atoms covalently bound through a sulfur bridge (—S—).In one embodiment, the alkoxy group is optionally substituted asdescribed above.

“Alkenyloxy” is an alkenyl group as defined covalently bound to thegroup it substitutes by an oxygen bridge (—O—).

“Alkanoyl” is an alkyl group as defined above covalently bound through acarbonyl (C═O) bridge. The carbonyl carbon is included in the number ofcarbons, that is C₂alkanoyl is a CH₃(C═O)— group. In one embodiment, thealkanoyl group is optionally substituted as described above.

“Alkylester” is an alkyl group as defined herein covalently boundthrough an ester linkage. The ester linkage may be in eitherorientation, e.g., a group of the formula —O(C═O)alkyl or a group of theformula —(C═O)Oalkyl.

“Amide” or “carboxamide” is —C(O)NR^(a)R^(b) wherein R^(a) and R^(b) areeach independently selected from hydrogen, alkyl, for example,C₁-C₆alkyl, alkenyl, for example, C₂-C₆alkenyl, alkynyl, for example,C₂-C₆alkynyl, —C₀-C₄alkyl(C₃-C₇cycloalkyl),—C₀-C₄alkyl(C₃-C₇heterocycloalkyl), —C₀-C₄alkyl(aryl), and—C₀-C₄alkyl(heteroaryl); or together with the nitrogen to which they arebonded, R^(a) and R^(b) can form a C₃-C₇heterocyclic ring. In oneembodiment, the R^(a) and R^(b) groups are each independently optionallysubstituted as described above.

“Carbocyclic group”, “carbocyclic ring”, or “cycloalkyl” is a saturatedor partially unsaturated (i.e., not aromatic) group containing allcarbon ring atoms. A carbocyclic group typically contains 1 ring of 3 to7 carbon atoms or 2 fused rings each containing 3 to 7 carbon atoms.Cycloalkyl substituents may be pendant from a substituted nitrogen orcarbon atom, or a substituted carbon atom that may have two substituentscan have a cycloalkyl group, which is attached as a spiro group.Examples of carbocyclic rings include cyclohexenyl, cyclohexyl,cyclopentenyl, cyclopentyl, cyclobutenyl, cyclobutyl and cyclopropylrings. In one embodiment, the carbocyclic ring is optionally substitutedas described above. In one embodiment, the cycloalkyl is a partiallyunsaturated (i.e., not aromatic) group containing all carbon ring atoms.In another embodiment, the cycloalkyl is a saturated group containingall carbon ring atoms.

“Carbocyclic-oxy group” is a monocyclic carbocyclic ring or a mono- orbi-cyclic carbocyclic group as defined above attached to the group itsubstitutes via an oxygen, —O—, linker.

“Haloalkyl” indicates both branched and straight-chain alkyl groupssubstituted with 1 or more halogen atoms, up to the maximum allowablenumber of halogen atoms. Examples of haloalkyl include, but are notlimited to, trifluoromethyl, monofluoromethyl, difluoromethyl,2-fluoroethyl, and penta-fluoroethyl.

“Haloalkoxy” indicates a haloalkyl group as defined herein attachedthrough an oxygen bridge (oxygen of an alcohol radical).

“Hydroxyalkyl” is an alkyl group as previously described, substitutedwith at least one hydroxyl substituent.

“Aminoalkyl” is an alkyl group as previously described, substituted withat least one amino substituent.

“Halo” or “halogen” indicates independently any of fluoro, chloro,bromo, and iodo.

“Aryl” indicates aromatic groups containing only carbon in the aromaticring or rings. In one embodiment, the aryl groups contain 1 to 3separate or fused rings and is 6 to about 14 or 18 ring atoms, withoutheteroatoms as ring members. When indicated, such aryl groups may befurther substituted with carbon or non-carbon atoms or groups. Suchsubstitution may include fusion to a 5 to 7-membered saturated cyclicgroup that optionally contains 1 or 2 heteroatoms independently chosenfrom N, O, and S, to form, for example, a 3,4-methylenedioxyphenylgroup. Aryl groups include, for example, phenyl and naphthyl, including1-naphthyl and 2-naphthyl. In one embodiment, aryl groups are pendant.An example of a pendant ring is a phenyl group substituted with a phenylgroup. In one embodiment, the aryl group is optionally substituted asdescribed above.

The term “heterocycle,” or “heterocyclic ring” as used herein refers toa saturated or a partially unsaturated (i.e., having one or more doubleand/or triple bonds within the ring without aromaticity) carbocyclicradical of 3 to about 12, and more typically 3, 5, 6, 7 to 10 ring atomsin which at least one ring atom is a heteroatom selected from nitrogen,oxygen, phosphorus and sulfur, the remaining ring atoms being C, whereone or more ring atoms is optionally substituted independently with oneor more substituents described above. A heterocycle may be a monocyclehaving 3 to 7 ring members (2 to 6 carbon atoms and 1 to 4 heteroatomsselected from N, O, P, and S) or a bicycle having 6 to 10 ring members(4 to 9 carbon atoms and 1 to 6 heteroatoms selected from N, O, P, andS), for example: a bicyclo[4,5], [5,5], [5,6], or [6,6] system. In oneembodiment, the only heteroatom is nitrogen. In one embodiment, the onlyheteroatom is oxygen. In one embodiment, the only heteroatom is sulfur.Heterocycles are described in Paquette, Leo A.; “Principles of ModernHeterocyclic Chemistry” (W. A. Benjamin, New York, 1968), particularlyChapters 1, 3, 4, 6, 7, and 9; “The Chemistry of Heterocyclic Compounds,A series of Monographs” (John Wiley & Sons, New York, 1950 to present),in particular Volumes 13, 14, 16, 19, and 28; and J. Am. Chem. Soc.(1960) 82:5566. Examples of heterocyclic rings include, but are notlimited to, pyrrolidinyl, dihydrofuranyl, tetrahydrothienyl,tetrahydropyranyl, dihydropyranyl, tetrahydrothiopyranyl, piperidino,piperidonyl, morpholino, thiomorpholino, thioxanyl, piperazinyl,homopiperazinyl, azetidinyl, oxetanyl, thietanyl, homopiperidinyl,oxepanyl, thiepanyl, oxazepinyl, diazepinyl, thiazepinyl, 2-pyrrolinyl,3-pyrrolinyl, indolinyl, 2H-pyranyl, 4H-pyranyl, dioxanyl,1,3-dioxolanyl, pyrazolinyl, dithianyl, dithiolanyl, dihydropyranyl,dihydrothienyl, dihydrofuranyl, dihydroisoquinolinyl,tetrahydroisoquinolinyl, pyrazolidinylimidazolinyl, imidazolidinyl,2-oxa-5-azabicyclo[2.2.2]octane, 3-oxa-8-azabicyclo[3.2.1]octane,8-oxa-3-azabicyclo[3.2.1]octane, 6-oxa-3-azabicyclo[3.1.1]heptane,2-oxa-5-azabicyclo[2.2.1]heptane, 3-azabicyclo[3.1.0]hexanyl,3-azabicyclo[4.1.0]heptanyl, azabicyclo[2.2.2]hexanyl, 3H-indolyl,quinolizinyl, N-pyridyl ureas, and pyrrolopyrimidine. Spiro moieties arealso included within the scope of this definition. Examples of aheterocyclic group wherein 1 or 2 ring carbon atoms are substituted withoxo (═O) moieties are pyrimidinonyl and 1,1-dioxo-thiomorpholinyl. Theheterocycle groups herein are optionally substituted independently withone or more substituents described herein.

“Heterocyclicoxy group” is a monocyclic heterocyclic ring or a bicyclicheterocyclic group as described previously linked to the group itsubstitutes via an oxygen, —O—, linker.

“Heteroaryl” indicates a stable monocyclic aromatic ring which containsfrom 1 to 3, or in some embodiments from 1 to 2, heteroatoms chosen fromN, O, and S, with remaining ring atoms being carbon, or a stablebicyclic or tricyclic system containing at least one 5- to 7-memberedaromatic ring which contains from 1 to 3, or in some embodiments from 1to 2, heteroatoms chosen from N, O, and S, with remaining ring atomsbeing carbon. In one embodiment, the only heteroatom is nitrogen. In oneembodiment, the only heteroatom is oxygen. In one embodiment, the onlyheteroatom is sulfur. Monocyclic heteroaryl groups typically have from 5to 7 ring atoms. In some embodiments bicyclic heteroaryl groups are 9-to 10-membered heteroaryl groups, that is, groups containing 9 or 10ring atoms in which one 5- to 7-member aromatic ring is fused to asecond aromatic or non-aromatic ring. When the total number of S and Oatoms in the heteroaryl group exceeds 1, these heteroatoms are notadjacent to one another. In one embodiment, the total number of S and Oatoms in the heteroaryl group is not more than 2. In another embodiment,the total number of S and O atoms in the aromatic heterocycle is notmore than 1. Examples of heteroaryl groups include, but are not limitedto, pyridinyl (including, for example, 2-hydroxypyridinyl), imidazolyl,imidazopyridinyl, pyrimidinyl (including, for example,4-hydroxypyrimidinyl), pyrazolyl, triazolyl, pyrazinyl, tetrazolyl,furyl, thienyl, isoxazolyl, thiazolyl, oxadiazolyl, oxazolyl,isothiazolyl, pyrrolyl, quinolinyl, isoquinolinyl,tetrahydroisoquinolinyl, indolyl, benzimidazolyl, benzofuranyl,cinnolinyl, indazolyl, indolizinyl, phthalazinyl, pyridazinyl,triazinyl, isoindolyl, pteridinyl, purinyl, oxadiazolyl, triazolyl,thiadiazolyl, thiadiazolyl, furazanyl, benzofurazanyl, benzothiophenyl,benzothiazolyl, benzoxazolyl, quinazolinyl, quinoxalinyl,naphthyridinyl, tetrahydrofuranyl, and furopyridinyl. Heteroaryl groupsare optionally substituted independently with one or more substituentsdescribed herein. “Heteroaryloxy” is a heteroaryl group as describedbound to the group it substituted via an oxygen, —O—, linker.

“Heterocycloalkyl” is a saturated ring group. It may have, for example,1, 2, 3, or 4 heteroatoms independently chosen from N, S, and O, withremaining ring atoms being carbon. In a typical embodiment, nitrogen isthe heteroatom. Monocyclic heterocycloalkyl groups typically have from 3to about 8 ring atoms or from 4 to 6 ring atoms. Examples ofheterocycloalkyl groups include morpholinyl, piperazinyl, piperidinyl,and pyrrolinyl.

The term “mono- and/or di-alkylamino” indicates secondary or tertiaryalkylamino groups, wherein the alkyl groups are independently chosenalkyl groups, as defined herein. The point of attachment of thealkylamino group is on the nitrogen. Examples of mono- and di-alkylaminogroups include ethylamino, dimethylamino, and methyl-propyl-amino.

A “dosage form” means a unit of administration of an active agent.Examples of dosage forms include tablets, capsules, injections,suspensions, liquids, emulsions, implants, particles, spheres, creams,ointments, suppositories, inhalable forms, transdermal forms, buccal,sublingual, topical, gel, mucosal, and the like. A “dosage form” canalso include an implant, for example an optical implant.

“Pharmaceutical compositions” are compositions comprising at least oneactive agent, such as a compound or salt of Formula I, and at least oneother substance, such as a carrier. “Pharmaceutical combinations” arecombinations of at least two active agents which may be combined in asingle dosage form or provided together in separate dosage forms withinstructions that the active agents are to be used together to treat anydisorder described herein.

“Pharmaceutically acceptable salts” includes derivatives of thedisclosed compounds in which the parent compound is modified by makinginorganic and organic, non-toxic, acid or base addition salts thereof.The salts of the present compounds can be synthesized from a parentcompound that contains a basic or acidic moiety by conventional chemicalmethods. Generally, such salts can be prepared by reacting free acidforms of these compounds with a stoichiometric amount of the appropriatebase (such as Na, Ca, Mg, or K hydroxide, carbonate, bicarbonate, or thelike), or by reacting free base forms of these compounds with astoichiometric amount of the appropriate acid. Such reactions aretypically carried out in water or in an organic solvent, or in a mixtureof the two. Generally, non-aqueous media like ether, ethyl acetate,ethanol, isopropanol, or acetonitrile are typical, where practicable.Salts of the present compounds further include solvates of the compoundsand of the compound salts.

Examples of pharmaceutically acceptable salts include, but are notlimited to, mineral or organic acid salts of basic residues such asamines; alkali or organic salts of acidic residues such as carboxylicacids; and the like. The pharmaceutically acceptable salts include theconventional non-toxic salts and the quaternary ammonium salts of theparent compound formed, for example, from non-toxic inorganic or organicacids. For example, conventional non-toxic acid salts include thosederived from inorganic acids such as hydrochloric, hydrobromic,sulfuric, sulfamic, phosphoric, nitric and the like; and the saltsprepared from organic acids such as acetic, propionic, succinic,glycolic, stearic, lactic, malic, tartaric, citric, ascorbic, pamoic,maleic, hydroxymaleic, phenylacetic, glutamic, benzoic, salicylic,mesylic, esylic, besylic, sulfanilic, 2-acetoxybenzoic, fumaric,toluenesulfonic, methanesulfonic, ethane disulfonic, oxalic, isethionic,HOOC—(CH₂)_(m)—COOH where n is 0-4, and the like. Lists of additionalsuitable salts may be found, e.g., in Remington's PharmaceuticalSciences, 17th ed., Mack Publishing Company, Easton, Pa., p. 1418(1985).

The term “carrier” applied to pharmaceutical compositions/combinationsof the invention refers to a diluent, excipient, or vehicle with whichan active compound is provided.

A “pharmaceutically acceptable excipient” means an excipient that isuseful in preparing a pharmaceutical composition/combination that isgenerally safe, non-toxic and neither biologically nor otherwiseinappropriate for administration to a host, and includes, in oneembodiment, an excipient that is acceptable for veterinary use as wellas human pharmaceutical use. A “pharmaceutically acceptable excipient”as used in the present application includes both one and more than onesuch excipient.

A “patient” or “host” or “subject” is a human or non-human animal inneed of modulation of the complement factor D pathway. Typically thehost is a human. A “patient” or “host” or “subject” also refers to forexample, mammals, primates (e.g., humans), cows, sheep, goats, horses,dogs, cats, rabbits, rats, mice, fish, birds and the like.

A “prodrug” as used herein, means a compound which when administered toa host in vivo is converted into a parent drug. As used herein, the term“parent drug” means any of the presently described chemical compoundsthat are useful to treat any of the disorders described herein, or tocontrol or improve the underlying cause or symptoms associated with anyphysiological or pathological disorder described herein in a host,typically a human. Prodrugs can be used to achieve any desired effect,including to enhance properties of the parent drug or to improve thepharmaceutic or pharmacokinetic properties of the parent. Prodrugstrategies exist which provide choices in modulating the conditions forin vivo generation of the parent drug, all of which are deemed includedherein. Nonlimiting examples of prodrug strategies include covalentattachment of removable groups, or removable portions of groups, forexample, but not limited to acylation, phosphorylation, phosphonylation,phosphoramidate derivatives, amidation, reduction, oxidation,esterification, alkylation, other carboxy derivatives, sulfoxy orsulfone derivatives, carbonylation or anhydride, among others.

“Providing a compound of Formula I with at least one additional activeagent” means the compound of Formula I and the additional activeagent(s) are provided simultaneously in a single dosage form, providedconcomitantly in separate dosage forms, or provided in separate dosageforms for administration separated by some amount of time that is withinthe time in which both the compound of Formula I and the at least oneadditional active agent are within the blood stream of a patient. Incertain embodiments the compound of Formula I and the additional activeagent need not be prescribed for a patient by the same medical careworker. In certain embodiments the additional active agent or agentsneed not require a prescription. Administration of the compound ofFormula I or the at least one additional active agent can occur via anyappropriate route, for example, oral tablets, oral capsules, oralliquids, inhalation, injection, suppositories or topical contact.

A “therapeutically effective amount” of a pharmaceuticalcomposition/combination of this invention means an amount effective,when administered to a patient, to provide a therapeutic benefit such asan amelioration of symptoms, e.g., an amount effective to decrease thesymptoms of a macular degeneration. In one embodiment, a therapeuticallyeffective amount is an amount sufficient to prevent a significantincrease or will significantly reduce the detectable level of complementfactor D in the patient's blood, serum, or tissues.

II. Detailed Description of the Active Compounds

According to the present invention, a compound of Formula I is provided:

as well as the pharmaceutically acceptable salts and compositionsthereof. Formula I can be considered to have a central core, an L-αsubstituent, and a (C═O)A substituent. It has been discovered that acompound of Formula I, or a pharmaceutically acceptable salt orcomposition thereof, wherein R¹² or R¹³ on the A group is an ether(R³²), is a superior inhibitor of complement factor D, and therefore canbe used as an effective amount to treat a host in need of complementfactor D modulation.

Non-limiting examples of compounds falling within Formula I withvariations in the variables e.g., A, B, R¹-R^(3′), and L, areillustrated below. The disclosure includes all combinations of thesedefinitions so long as a stable compound results.

Formulas II-XXX

In one aspect, the disclosure includes compounds and salts of FormulaII, III, IV, V, VI, VII, VIII, IX, ×, XI, XII, XIII, XIV, XV, XVI, XVII,XVIII, XIX, XX, XXI, XXII, XXIII, XXIV, XXV, XXVI, XXVII, XVIII, XXIXand XXX which are within the scope of Formula I. The variables shown inFormula II-XXX carry the definitions set forth in the SUMMARY sectionfor Formula I or any of the definitions set forth in this disclosure.

In these embodiments, it should be understood that where R¹ or R³ isattached to a carbon, there can be two independent attachments as inR²/R^(2′) and these formulas should be considered to include all suchvariations.

Additionally, the disclosure includes compounds and salts of Formula Iand pharmaceutically acceptable compositions thereof, and any of itssubformulae (II-XXX) in which at least one of the following conditionsis met in the embodiments described below.

The R¹² and R¹³ Ether Substituents

It has been discovered that a compound of Formula I, a pharmaceuticallyacceptable salt or composition thereof, wherein R¹² or R¹³ on the Agroup is an ether, is a superior inhibitor of complement factor D.

One of R¹² and R¹³ is chosen from R³¹ and the other of R¹² and R¹³ ischosen from R³². In another embodiment, each of R¹² and R¹³ can beindependently selected from R³².

R³¹ is chosen from hydrogen, halogen, hydroxyl, nitro, cyano, amino,—COOH, C₁-C₂haloalkyl, C₁-C₂haloalkoxy, C₁-C₆alkyl,—C₀-C₄alkyl(C₃-C₇cycloalkyl), C₂-C₆alkenyl, C₂-C₆alkanoyl, C₁-C₆alkoxy,C₂-C₆alkenyloxy, —C(O)OR⁹, C₁-C₆thioalkyl, —C₀-C₄alkylNR⁹R¹⁰,—C(O)NR⁹R¹⁰, —SO₂R⁹, —SO₂NR⁹R¹⁰, —OC(O)R⁹, and —C(NR⁹)NR⁹R¹⁰, each ofwhich R³¹ other than hydrogen, halogen, hydroxyl, nitro, cyano,C₁-C₂haloalkyl, and C₁-C₂haloalkoxy is unsubstituted or substituted withone or more substituents independently selected from halogen, hydroxyl,nitro, cyano, amino, —COOH, —CONH₂ C₁-C₂haloalkyl, and C₁-C₂haloalkoxy,and each of which R³¹ is also optionally substituted with onesubstituent chosen from phenyl and 4- to 7-membered heterocyclecontaining 1, 2, or 3 heteroatoms independently chosen from N, O, and S;which phenyl or 4- to 7-membered heterocycle is unsubstituted orsubstituted with one or more substituents independently chosen fromhalogen, hydroxyl, nitro, cyano, C₁-C₆alkyl, C₂-C₆alkenyl,C₂-C₆alkanoyl, C₁-C₆alkoxy, (mono- and di-C₁-C₆alkylamino)C₀-C₄alkyl,C₁-C₆alkylester, —C₀-C₄alkyl)(C₃-C₇cycloalkyl), C₁-C₂haloalkyl, andC₁-C₂haloalkoxy;

R³² is chosen from —O(CH₂)₁₋₄R^(23a), —OC₂-C₄alkenylR^(23a),—OC₂-C₄alkynylR²³, —O(CH₂)₁₋₄paracyclophane,—O(CH₂)₁₋₄P(O)R^(23b)R^(23b), —O(CH₂)₁₋₄S(O)NR²¹R²²,—O(CH₂)₁₋₄S(O)NR²⁴R²⁵, —O(CH₂)₁₋₄SO₂NR²¹R²², —O(CH₂)₁₋₄SO₂NR²⁴R²⁵,—O(C₃-C₇cycloalkyl), —O(aryl), —O(heteroaryl), and —O(heterocycle) andeach group can be optionally substituted as further described herein. Insome embodiments, R³² is —O(4- to 7-membered heterocycloalkyl) having 1,2, or 3 heteroatoms independently chosen from N, O, and S, and —O(5- or6-membered unsaturated or aromatic heterocycle) having 1, 2, or 3heteroatoms independently chosen from N, O, and S, and each group can beoptionally substituted.

R²¹ and R²² are independently chosen at each occurrence from hydrogen,hydroxyl, cyano, amino, C₁-C₆alkyl, C₁-C₆haloalkyl, C₁-C₆alkoxy,(C₃-C₇cycloalkyl)C₀-C₄alkyl, (phenyl)C₀-C₄alkyl,—C₁-C₄alkylOC(O)OC₁-C₆alkyl, —C₁-C₄alkylOC(O)C₁-C₆alkyl,—C₁-C₄alkylC(O)OC₁-C₆alkyl, (4- to 7-memberedheterocycloalkyl)C₀-C₄alkyl having 1, 2, or 3 heteroatoms independentlychosen from N, O, and S, and (5- or 6-membered unsaturated or aromaticheterocycle)C₀-C₄alkyl having 1, 2, or 3 heteroatoms independentlychosen from N, O, and S, and each R²¹ and R²² can be optionallysubstituted.

R²³ is independently chosen at each occurrence from C₁-C₆alkyl,C₁-C₆haloalkyl, (aryl)C₀-C₄alkyl, (C₃-C₇cycloalkyl)C₀-C₄alkyl,(phenyl)C₀-C₄alkyl, (4- to 7-membered heterocycloalkyl)C₀-C₄alkyl having1, 2, or 3 heteroatoms independently chosen from N, O, and S, and (5- or6-membered unsaturated or aromatic heterocycle)C₀-C₄alkyl having 1, 2,or 3 heteroatoms independently chosen from N, O, and S, and each R²³ canbe optionally substituted.

R^(23a) is independently chosen at each occurrence from(C₃-C₇cycloalkyl), and each R^(2′) can be optionally substituted.

R^(23b) is independently chosen at each occurrence from hydroxyl,C₁-C₆alkoxy, C₁-C₆alkyl, (C₃-C₇cycloalkyl)C₀-C₄alkyl,(phenyl)C₀-C₄alkyl, —O(CH₂)₂₋₄O(CH₂)₈₋₁₈, —OC(R^(23c))₂OC(O)OR^(23d),—OC(R^(23c))₂OC(O)R^(23d), an N-linked amino acid or an N-linked aminoacid ester, and each R^(23b) can be optionally substituted.

R^(23c) is independently chosen at each occurrence from hydrogen,C₁-C₈alkyl, C₂-C₈alkenyl, C₂-C₈alkynyl, (aryl)C₀-C₄alkyl,(aryl)C₂-C₈alkenyl- or (aryl)C₂-C₈alkynyl; or two R^(23c) groups can betaken together with the carbon that they are bonded to form a 3-6membered heterocycloalkyl having 1, 2, or 3 heteroatoms independentlychosen from N, O, and S, or a 3-6 membered carbocyclic ring, and eachR^(23c) can be optionally substituted.

R^(23d) is independently chosen at each occurrence from C₁-C₈alkyl,C₂-C₈alkenyl, C₂-C₈alkynyl, (aryl)C₀-C₄alkyl, (aryl)C₂-C₈alkenyl or(aryl)C₂-C₈alkynyl, and each R^(23d) can be optionally substituted.

R²⁴ and R²⁵ are taken together with the nitrogen to which they areattached to form a 4- to 7-membered monocyclic heterocycloalkyl group,or a 6- to 10-membered bicyclic heterocyclic group having fused, spiro,or bridged rings, and each R²⁴ and R²⁵ can be optionally substituted.

In certain embodiments, R³² is selected from:

As shown above, in one embodiment, two R^(23b) groups in aO(CH₂)₁₋₄P(O)R^(23b)R^(23b) moiety can come together to form aheterocyclic ring that can be optionally substituted with an R¹⁰⁰ group,wherein R¹⁰⁰ is aryl, heteroaryl, alkyl, cycloalkyl, heterocyclic,alkenyl or alkynyl. See for example: HepDirect (Cyclic1-aryl-1,3-propanyl esters) Prodrugs: Activation via CYP-mediatedoxidation of the benzylic carbon. See Hecker, S. J. et al. J. Med. Chem.2007, 50, 3891-3896.

Non-limiting R¹²/R¹³ Embodiments

In one embodiment, R¹² is R³².

In one embodiment, R¹³ is R³².

In one embodiment, R¹² is —O(CH₂)₁₋₄R^(23a).

In one embodiment, R¹² is —OC₂-C₄alkenylR^(23a).

In one embodiment, R¹² is —OC₂-C₄alkynylR²³.

In one embodiment, R¹² is —O(CH₂)₁₋₄paracyclophane.

In one embodiment, R¹² is —O(CH₂)₁₋₄P(O)R^(23b).

In one embodiment, R¹² is —O(CH₂)₁₋₄S(O)NR²¹R²².

In one embodiment, R¹² is —O(CH₂)₁₋₄S(O)NR²⁴R²⁵.

In one embodiment, R¹² is —O(CH₂)₁₋₄SO₂NR²¹R²².

In one embodiment, R¹² is —O(CH₂)₁₋₄SO₂NR²⁴R²⁵.

In one embodiment, R¹² is —O(C₃-C₇cycloalkyl).

In one embodiment, R¹² is —O(aryl).

In one embodiment, R¹² is optionally substituted —O(CH₂)₁₋₄R^(23a).

In one embodiment, R¹² is optionally substituted —OC₂-C₄alkenylR^(23a).

In one embodiment, R¹² is optionally substituted —OC₂-C₄alkynylR²³.

In one embodiment, R¹² is optionally substituted—O(CH₂)₁₋₄paracyclophane.

In one embodiment, R¹² is optionally substituted—O(CH₂)₁₋₄P(O)R^(23b)R^(23b).

In one embodiment, R¹² is optionally substituted —O(CH₂)₁₋₄S(O)NR²¹R²².

In one embodiment, R¹² is optionally substituted —O(CH₂)₁₋₄S(O)NR²⁴R²⁵.

In one embodiment, R¹² is optionally substituted —O(CH₂)₁₋₄SO₂NR²¹R²².

In one embodiment, R¹² is optionally substituted —O(CH₂)₁₋₄SO₂NR²⁴R²⁵.

In one embodiment, R¹² is optionally substituted —O(C₃-C₇cycloalkyl).

In one embodiment, R¹² is optionally substituted —O(aryl).

In one embodiment, R¹² is optionally substituted —O(heteroaryl).

In one embodiment, R¹² is optionally substituted —O(heterocycle).

In one embodiment, R¹³ is optionally substituted —O(CH₂)₁₋₄R^(23a).

In one embodiment, R¹³ is optionally substituted —OC₂-C₄alkenylR^(23a).

In one embodiment, R¹³ is optionally substituted —OC₂-C₄alkynylR²³.

In one embodiment, R¹³ is optionally substituted—O(CH₂)₁₋₄paracyclophane.

In one embodiment, R¹³ is optionally substituted—O(CH₂)₁₋₄P(O)R^(23b)R^(23b).

In one embodiment, R¹³ is optionally substituted —O(CH₂)₁₋₄S(O)NR²¹R²².

In one embodiment, R¹³ is optionally substituted —O(CH₂)₁₋₄S(O)NR²⁴R²⁵.

In one embodiment, R¹³ is optionally substituted —O(CH₂)₁₋₄SO₂NR²¹R²².

In one embodiment, R¹³ is optionally substituted —O(CH₂)₁₋₄SO₂NR²⁴R²⁵.

In one embodiment, R¹³ is optionally substituted —O(C₃-C₇cycloalkyl).

In one embodiment, R¹³ is optionally substituted —O(aryl).

In one embodiment, R¹³ is optionally substituted —O(heteroaryl).

In one embodiment, R¹³ is optionally substituted —O(heterocycle).

In one embodiment, R¹² is —O(4- to 7-membered heterocycloalkyl) having1, 2, or 3 heteroatoms independently chosen from N, O, and S.

In one embodiment, R¹² is —O(5- or 6-membered unsaturated or aromaticheterocycle) having 1, 2, or 3 heteroatoms independently chosen from N,O, and S.

In one embodiment, R¹³ is —O(CH₂)₁₋₄R^(23a).

In one embodiment, R¹³ is —OC₂-C₄alkenylR^(23a).

In one embodiment, R¹³ is —OC₂-C₄alkynylR²³.

In one embodiment, R¹³ is —O(CH₂)₁₋₄paracyclophane.

In one embodiment, R¹³ is —O(CH₂)₁₋₄P(O)R^(23b)R^(23b).

In one embodiment, R¹³ is —O(CH₂)₁₋₄S(O)NR²¹R²².

In one embodiment, R¹³ is —O(CH₂)₁₋₄S(O)NR²⁴R²⁵.

In one embodiment, R¹³ is —O(CH₂)₁₋₄SO₂NR²¹R²².

In one embodiment, R¹³ is —O(CH₂)₁₋₄SO₂NR²⁴R²⁵.

In one embodiment, R¹³ is —O(C₃-C₇cycloalkyl).

In one embodiment, R¹³ is —O(aryl).

In one embodiment, R¹³ is —O(4- to 7-membered heterocycloalkyl) having1, 2, or 3 heteroatoms independently chosen from N, O, and S.

In one embodiment, R¹³ is —O(5- or 6-membered unsaturated or aromaticheterocycle) having 1, 2, or 3 heteroatoms independently chosen from N,O, and S.

In one embodiment, the disclosure provides compounds of Formula I,wherein;

one of R¹² and R¹³ is H and the other of R¹² and R¹³ is R³², where

R³² is —O(CH₂)₁₋₄R^(23a), —OC₂-C₄alkenylR^(23a), —OC₂-C₄alkynylR²³,—O(CH₂)₁₋₄paracyclophane, —O(CH₂)₁₋₄P(O)R^(23b)R^(23b),—O(CH₂)₁₋₄S(O)NR²¹R²², —O(CH₂)₁₋₄S(O)NR²⁴R²⁵, —O(CH₂)₁₋₄SO₂NR²¹R²²,—O(CH₂)₁₋₄SO₂NR²⁴R²⁵, —O(C₃-C₇cycloalkyl), —O(aryl), —O(4- to 7-memberedheterocycloalkyl) having 1, 2, or 3 heteroatoms independently chosenfrom N, O, and S, and —O(5- or 6-membered unsaturated or aromaticheterocycle) having 1, 2, or 3 heteroatoms independently chosen from N,O, and S, and each group can be optionally substituted;

wherein R²¹, R²², R²³, R^(23a), R^(23b), R²⁴, and R²⁵ are as defined inthe summary section above.

In another embodiment, the disclosure provides compounds of Formula I,wherein;

R¹, R^(1′), R², and R^(3′) are all hydrogen;

R² is fluoro and R³ is hydrogen, —C₀-C₄alkyl(C₃-C₇cycloalkyl), or—O—C₀-C₄alkyl(C₃-C₇cycloalkyl);

R⁵ is hydrogen, halogen, or C₁-C₂alkyl;

R¹¹, R¹³, R¹⁴, and R¹⁵ if present, are independently chosen at eachoccurrence from hydrogen, halogen, hydroxyl, amino, C₁-C₄alkyl,C₁-C₄alkoxy, —C₀-C₂alkyl(mono- and di-C₁-C₂alkylamino), trifluoromethyl,and trifluoromethoxy;

X¹² is CR¹²; and

R¹² is —O(CH₂)₁₋₄R^(23a), —OC₂-C₄alkenylR^(23a), —OC₂-C₄alkynylR²³,—O(CH₂)₁₋₄ paracyclophane, —O(CH₂)₁₋₄P(O)R^(23b)R^(23b),—O(CH₂)₁₋₄S(O)NR²¹R²², —O(CH₂)₁₋₄S(O)NR²⁴R²⁵, —O(CH₂)₁₋₄SO₂NR²¹R²²,—O(CH₂)₁₋₄SO₂NR²⁴R²⁵, —O(C₃-C₇cycloalkyl), —O(aryl), —O(4- to 7-memberedheterocycloalkyl) having 1, 2, or 3 heteroatoms independently chosenfrom N, O, and S, and —O(5- or 6-membered unsaturated or aromaticheterocycle) having 1, 2, or 3 heteroatoms independently chosen from N,O, and S, and each group can be optionally substituted;

wherein R²¹, R²², R²³, R^(23a), R^(23b), R²⁴, and R²⁵ are as defined inthe summary section above.

In one embodiment, the disclosure provides compounds of Formula I,wherein;

m is 0 or 1;

R² is halogen, R^(2′) is hydrogen or halogen, and R³ is hydrogen,halogen, —C₀-C₄alkyl(C₃-C₇cycloalkyl), or—O—C₀-C₄alkyl(C₃-C₇cycloalkyl);

R⁶ is —C(O)C₁-C₄alkyl, —C(O)NH₂, —C(O)CF₃, —C(O)(C₃-C₇cycloalkyl), or-ethyl(cyanoimino);

one of R¹² and R¹³ is selected from hydrogen, halogen, C₁-C₄alkyl,C₁-C₄alkoxy, trifluoromethyl, and trifluoromethoxy; the other of R¹² andR¹³ is R³², where

R³² is —O(CH₂)₁₋₄R^(23a), —OC₂-C₄alkenylR^(23a), —OC₂-C₄alkynylR²³,—O(CH₂)₁₋₄ paracyclophane, —O(CH₂)₁₋₄P(O)R^(23b)R^(23b),—O(CH₂)₁₋₄S(O)NR²¹R²², —O(CH₂)₁₋₄S(O)NR²⁴R²⁵, —O(CH₂)₁₋₄SO₂NR²¹R²²,—O(CH₂)₁₋₄SO₂NR²⁴R²⁵, —O(C₃-C₇cycloalkyl), —O(aryl), —O(4- to 7-memberedheterocycloalkyl) having 1, 2, or 3 heteroatoms independently chosenfrom N, O, and S, and —O(5- or 6-membered unsaturated or aromaticheterocycle) having 1, 2, or 3 heteroatoms independently chosen from N,O, and S, and each group can be optionally substituted;

wherein R²¹, R²², R²³, R^(23a), R^(23b), R²⁴, and R²⁵ are as defined inthe summary section above.

In one embodiment, the disclosure provides compounds of Formula I,wherein;

one of R¹² and R¹³ is hydrogen, hydroxyl, halogen, methyl, or methoxy;and the other of R¹² and R¹³ is R³², where

R³² is —O(CH₂)₁₋₄R^(23a), —OC₂-C₄alkenylR^(23a), —OC₂-C₄alkynylR²³,—O(CH₂)₁₋₄ paracyclophane, —O(CH₂)₁₋₄P(O)R^(23b)R^(23b),—O(CH₂)₁₋₄S(O)NR²¹R²², —O(CH₂)₁₋₄S(O)NR²⁴R²⁵, —O(CH₂)₁₋₄SO₂NR²¹R²²,—O(CH₂)₁₋₄SO₂NR²⁴R²⁵, —O(C₃-C₇cycloalkyl), —O(aryl), —O(4- to 7-memberedheterocycloalkyl) having 1, 2, or 3 heteroatoms independently chosenfrom N, O, and S, and —O(5- or 6-membered unsaturated or aromaticheterocycle) having 1, 2, or 3 heteroatoms independently chosen from N,O, and S, and each group can be optionally substituted;

wherein R²¹, R²², R²³, R^(23a), R^(23b), R²⁴, and R²⁵ are as defined inthe summary section above.

In one embodiment, R³² may be unsubstituted or substituted with one ormore substituents independently chosen from halogen, hydroxyl, nitro,cyano, amino, oxo, —B(OH)₂, —Si(CH₃)₃, —COOH, —CONH₂, —P(O)(OH)₂,C₁-C₆alkyl, C₁-C₆alkoxy, —C₀-C₂alkyl(mono- and di-C₁-C₄alkylamino),C₁-C₆alkylester, C₁-C₄alkylamino, C₁-C₄hydroxylalkyl, C₁-C₂haloalkyl,and C₁-C₂haloalkoxy.

Central Core Moiety

The central core moiety in Formula I is illustrated below:

wherein:

Q¹ is N(R¹) or C(R¹R^(1′));

Q² is C(R²R^(2′)), C(R²R^(2′))—C(R²R^(2′)), S, O, N(R²) or C(R²R^(2′))O;

Q³ is N(R³), S, or C(R³R^(3′));

X¹ and X² are independently N, CH, or CZ, or X¹ and X² together are C≡C;and

wherein Q¹, Q², Q³, X¹, and X² are selected such that a stable compoundresults.

Non-limiting examples of the

ring are illustrated below (any of which can be otherwise substitutedwith R¹, R^(1′), R², R^(2′), R³, and R^(3′)) as described in more detailbelow.

wherein q is 0, 1, 2 or 3 and r is 1, 2 or 3.

R and R′ are independently chosen from H, alkyl, cycloalkyl,cycloalkylalkyl, heterocycle, heterocycloalkyl, aryl, aralkyl,heteroaryl, heteroarylalkyl wherein each group can be optionallysubstituted or any other substituent group herein that provides thedesired properties. In some embodiments, the ring includes one or morechiral carbon atoms. The invention includes embodiments in which thechiral carbon can be provided as an enantiomer, or mixtures ofenantiomers, including a racemic mixture. Where the ring includes morethan one stereocenter, all of the enantiomers and diastereomers areincluded in the invention as individual species.

Z is F, Cl, NH₂, CH₃, CH₂D, CHD₂, or CD₃.

R¹, R^(1′), R², R^(2′), R³, and R^(3′) are independently chosen at eachoccurrence, as appropriate, and only where a stable compound results,from hydrogen, halogen, hydroxyl, nitro, cyano, amino, C₁-C₆alkyl,C₂-C₆alkenyl, C₂-C₆alkynyl, C₁-C₆alkoxy, C₂-C₆alkynyl, C₂-C₆alkanoyl,C₁-C₆thioalkyl, hydroxyC₁-C₆alkyl, aminoC₁-C₆alkyl, —C₀-C₄alkylNR⁹R¹⁰,—C(O)OR⁹, —OC(O)R⁹, —NR⁹C(O)R¹⁰, —C(O)NR⁹R¹⁰, —OC(O)NR⁹R¹⁰,—NR⁹C(O)OR¹⁰, C₁-C₂haloalkyl, and C₁-C₂haloalkoxy, where R⁹ and R¹⁰ areindependently chosen at each occurrence from hydrogen, C₁-C₆alkyl,(C₃-C₇cycloalkyl)C₀-C₄alkyl, —C₀-C₄alkyl(C₃-C₇cycloalkyl), and—O—C₀-C₄alkyl(C₃-C₇cycloalkyl).

Non-limiting Central Core Embodiments

In alternative embodiments, R¹ and R^(1′) or R³ and R^(3′) may be takentogether to form a 3- to 6-membered carbocyclic spiro ring or a 3- to6-membered heterocyclic spiro ring containing 1 or 2 heteroatomsindependently chosen from N, O, or S; R² and R^(2′) may be takentogether to form a 3- to 6-membered carbocyclic spiro ring; or R² andR^(2′) may be taken together to form a 3- to 6-membered heterocyclicspiro ring; each of which ring may be unsubstituted or substituted with1 or more substituents independently chosen from halogen (and inparticular F), hydroxyl, cyano, —COOH, C₁-C₄alkyl (including inparticular methyl), C₂-C₄alkenyl, C₂-C₄alkynyl, C₁-C₄alkoxy,C₂-C₄alkanoyl, hydroxyC₁-C₄alkyl, (mono- anddi-C₁-C₄alkylamino)C₀-C₄alkyl, —C₀-C₄alkyl(C₃-C₇cycloalkyl),—O—C₀-C₄alkyl(C₃-C₇cycloalkyl), C₁-C₂haloalkyl, and C₁-C₂haloalkoxy.

In alternative embodiments, R¹ and R² may be taken together to form a3-membered carbocyclic ring; R¹ and R² may be taken together to form a4- to 6-membered carbocyclic or aryl ring or a 4- to 6-memberedheterocyclic or heteroaryl ring containing 1 or 2 heteroatomsindependently chosen from N, O, and S; or R² and R³, if bound toadjacent carbon atoms, may be taken together to form a 3- to 6-memberedcarbocyclic or aryl ring or a 3- to 6-membered heterocyclic orheteroaryl ring; each of which ring may be unsubstituted or substitutedwith 1 or more substituents independently chosen from halogen (and inparticular F), hydroxyl, cyano, —COOH, C₁-C₄alkyl (including inparticular methyl), C₂-C₄alkenyl, C₂-C₄alkynyl, C₁-C₄alkoxy,C₂-C₄alkanoyl, hydroxyC₁-C₄alkyl, (mono- anddi-C₁-C₄alkylamino)C₀-C₄alkyl, —C₀-C₄alkyl(C₃-C₇cycloalkyl),—O—C₀-C₄alkyl(C₃-C₇cycloalkyl), C₁-C₂haloalkyl, and C₁-C₂haloalkoxy.

In one embodiment, the central core moiety is proline.

In one embodiment, the central core moiety is 4-fluoroproline.

In one embodiment, R¹, R^(1′), R^(2′), R³, and R^(3′), if present, areall hydrogen; and R² is fluoro.

In one embodiment, R¹, R^(1′), R^(2′), and R^(3′), if present, are allhydrogen; and R² is fluoro and R³ is —C₀-C₄alkyl(C₃-C₇cycloalkyl) or—O—C₀-C₄alkyl(C₃-C₇cycloalkyl).

In one embodiment, R¹ and R² are taken together to form a 3- to6-membered cycloalkyl group, and R^(1′), R^(2′), R³, and R^(3′), wherepresent, are all hydrogen.

In one embodiment, R′, R^(1′), R³, and R^(3′), if present, are allhydrogen, and R² and R^(2′) are taken together to form a 5- or6-membered heterocycloalkyl group having 1 or 2 oxygen atoms.

In one embodiment, R¹ is hydrogen and R² is fluoro.

In one embodiment, R¹ and R² are joined to form a 3 membered ring.

The disclosure includes compounds of Formula I in which the centralpyrrolidine is vinyl substituted, for example:

In one embodiment, the compound of Formula I has the structure:

In one embodiment, the central pyrrolidine is modified by addition of asecond heteroatom to a pyrrolidine ring, such as N, O, S, or Si, forexample:

Another modification within the scope of the disclosure is joining asubstituent on the central pyrrolidine ring to R⁷ or R⁸ to form a 5- to6-membered heterocyclic ring, for example:

Example of compounds having the modifications disclosed above include:

Central Core L-α Substituents

The central core L-α substituents in Formula I are illustrated below:

L is a bond or is chosen from the formulas:

where R¹⁷ is hydrogen, C₁-C₆alkyl, or —C₀-C₄alkyl(C₃-C₇cycloalkyl) andR¹⁸ and R^(18′) are independently chosen from hydrogen, halogen,hydroxymethyl, and methyl; and m is 0, 1, 2, or 3.

B is a monocyclic or bicyclic carbocyclic; a monocyclic or bicycliccarbocyclic-oxy group; a monocyclic, bicyclic, or tricyclic heterocyclicgroup having 1, 2, 3, or 4 heteroatoms independently selected from N, O,and S and from 4 to 7 ring atoms per ring; C₂-C₆alkenyl; C₂-C₆alkynyl;—(C₀-C₄alkyl)(aryl); —(C₀-C₄alkyl)(heteroaryl); or—(C₀-C₄alkyl)(biphenyl).

Each of which B is unsubstituted or substituted with one or moresubstituents independently chosen from R³³ and R³⁴, and 0 or 1substituents chosen from R³⁵ and R³⁶:

R³³ is independently chosen from halogen, hydroxyl, —COOH, cyano,C₁-C₆alkyl, C₂-C₆alkanoyl, C₁-C₆alkoxy, —C₀-C₄alkylNR⁹R¹⁰, —SO₂R⁹,C₁-C₂haloalkyl, and C₁-C₂haloalkoxy;

R³⁴ is independently chosen from nitro, C₂-C₆alkenyl, C₂-C₆alkynyl,C₁-C₆thioalkyl, -JC₃-C₇cycloalkyl, —B(OH)₂, -JC(O)NR⁹R²³, -JOSO₂OR²¹,—C(O)(CH₂)₁₋₄S(O)R²¹, —O(CH₂)₁₋₄S(O)NR²¹R²², -JOP(O)(OR²¹)(OR²²),-JP(O)(OR²¹)(OR²²), -JOP(O)(OR²¹)R²², -JP(O)(OR²¹)R²², -JOP(O)R²¹R²²,-JP(O)R²¹R²², -JSP(O)(OR²¹)(OR²²), -JSP(O)(OR²¹)(R²²),-JSP(O)(R²¹)(R²²), -JNR⁹P(O)(NHR²¹)(NHR²²), -JNR⁹P(O)(OR²¹)(NHR²²),-JNR⁹P(O)(OR²¹)(OR²²), -JC(S)R²¹, -JNR²¹SO₂R²², -JNR⁹S(O)NR¹⁰R²²,-JNR⁹SO₂NR¹⁰R²², -JSO₂NR⁹COR²², -JSO₂NR⁹CONR²¹R²², -JNR²¹SO₂R²²,-JC(O)NR²¹SO₂R²², -JC(NH₂)NR²², -JC(NH₂)NR⁹S(O)₂R²², -JOC(O)NR²¹R²²,-JNR²¹C(O)OR²², -JNR²¹OC(O)R²², —(CH₂)₁₋₄C(O)NR²¹R²², -JC(O)R²⁴R²⁵,-JNR⁹C(O)R²¹, -JC(O)R²¹, -JNR⁹C(O)NR¹⁰R²², —CCR²¹, —(CH₂)₁₋₄OC(O)R²¹,and -JC(O)OR²³; each of which R³⁴ may be unsubstituted or substitutedwith one or more substituents independently chosen from halogen,hydroxyl, nitro, cyano, amino, oxo, —B(OH)₂, —Si(CH₃)₃, —COOH, —CONH₂,—P(O)(OH)₂, C₁-C₆alkyl, —C₀-C₄alkyl(C₃-C₇cycloalkyl), C₁-C₆alkoxy,—C₀-C₂alkyl(mono- and di-C₁-C₄alkylamino), C₁-C₆alkylester,C₁-C₄alkylamino, C₁-C₄hydroxylalkyl, C₁-C₂haloalkyl, andC₁-C₂haloalkoxy;

R³⁵ is independently chosen from naphthyl, naphthyloxy, indanyl, (4- to7-membered heterocycloalkyl)C₀-C₄alkyl containing 1 or 2 heteroatomschosen from N, O, and S, and bicyclic heterocycle containing 1, 2, or 3heteroatoms independently chosen from N, O, and S, and containing 4- to7-ring atoms in each ring; each of which R³⁵ is unsubstituted orsubstituted with one or more substituents independently chosen fromhalogen, hydroxyl, nitro, cyano, C₁-C₆alkyl, C₂-C₆alkenyl,C₂-C₆alkanoyl, C₁-C₆alkoxy, (mono- and di-C₁-C₆alkylamino)C₀-C₄alkyl,C₁-C₆alkylester, —C₀-C₄alkyl(C₃-C₇cycloalkyl), —SO₂R⁹, C₁-C₂haloalkyl,and C₁-C₂haloalkoxy; and

R³⁶ is independently chosen from tetrazolyl, (phenyl)C₀-C₂alkyl,(phenyl)C₁-C₂alkoxy, phenoxy, and 5- or 6-membered heteroaryl containing1, 2, or 3 heteroatoms independently chosen from N, O, B, and S, each ofwhich R³⁶ is unsubstituted or substituted with one or more substituentsindependently chosen from halogen, hydroxyl, nitro, cyano, C₁-C₆alkyl,C₂-C₆alkenyl, C₂-C₆alkanoyl, C₁-C₆alkoxy, (mono- anddi-C₁-C₆alkylamino)C₀-C₄alkyl, C₁-C₆alkylester,—C₀-C₄alkyl(C₃-C₇cycloalkyl), —SO₂R⁹, —OSi(CH₃)₂C(CH₃)₃,—Si(CH₃)₂C(CH₃)₃, C₁-C₂haloalkyl, and C₁-C₂haloalkoxy.

J is independently chosen at each occurrence from a covalent bond,C₁-C₄alkylene, —OC₁-C₄alkylene, C₂-C₄alkenylene, and C₂-C₄alkynylene.

In one embodiment, -L-α— is

where R²⁶ and R²⁷ are independently chosen from hydrogen, halogen,hydroxyl, nitro, cyano, C₁-C₆alkyl, C₂-C₆alkenyl, C₂-C₆alkanoyl,C₁-C₆alkoxy, C₁-C₆thioalkyl, —C₀-C₄alkyl(mono- and di-C₁-C₆alkylamino),—C₀-C₄alkyl(C₃-C₇cycloalkyl), —C₀-C₄alkoxy(C₃-C₇cycloalkyl),C₁-C₂haloalkyl, C₁-C₂haloalkoxy, and C₁-C₂haloalkylthio.

Non-Limiting L-α Embodiments

In another embodiment, -L-α— is

wherein

R¹⁸ and R^(18′) are independently chosen from hydrogen, halogen,hydroxymethyl, and methyl; and m is 0 or 1; and

R²⁶, R²⁷, and R²⁸ are independently chosen from hydrogen, halogen,hydroxyl, nitro, cyano, C₁-C₆alkyl, C₂-C₆alkenyl, C₂-C₆alkanoyl,C₁-C₆alkoxy, C₁-C₆thioalkyl, (mono- and di-C₁-C₆alkylamino)C₀-C₄alkyl,(C₃-C₇cycloalkyl)C₀-C₄alkyl, (aryl)C₀-C₄alkyl-, (heteroaryl)C₀-C₄alkyl-,and —C₀-C₄alkoxy(C₃-C₇cycloalkyl); each of which R²⁶, R²⁷, and R²⁸ otherthan hydrogen, halogen, hydroxyl, nitro, cyano, is unsubstituted orsubstituted with one or more substituents independently chosen fromhalogen, hydroxyl, amino, C₁-C₂alkoxy, C₁-C₂haloalkyl,(C₃-C₇cycloalkyl)C₀-C₄alkyl-, and C₁-C₂haloalkoxy; and

R²⁹ is hydrogen, C₁-C₂alkyl, C¹C₂haloalkyl or —Si(CH₃)₂C(CH₃)₃.

In one embodiment, m is 0.

In one embodiment, the disclosure further includes compounds and saltsof Formula I in which B is 2-fluoro-3-chlorophenyl. In anotherembodiment, another carbocyclic, aryl, heterocyclic, or heteroaryl groupsuch as 2-bromo-pyridin-6-yl, 1-(2,2,2-trifluoroethyl)-1H-pyrazol-3-yl,2,2-dichlorocyclopropylmethyl, or 2-fluoro-3-trimethylsilylphenyl isused.

In another embodiment, B is phenyl, pyridyl, or indanyl each of which isunsubstituted or substituted with one or more substituents independentlychosen from hydrogen, halogen, hydroxyl, nitro, cyano, C₁-C₆alkyl,C₂-C₆alkenyl, C₂-C₆alkanoyl, C₁-C₆alkoxy, C₁-C₆thioalkyl, (mono- anddi-C₁-C₆alkylamino)C₀-C₄alkyl, (C₃-C₇cycloalkyl)C₀-C₄alkyl,—C₀-C₄alkoxy(C₃-C₇cycloalkyl), (phenyl)C₀-C₂alkyl, (pyridyl)C₀-C₂alkyl;each of which substituents other than hydrogen, halogen, hydroxyl,nitro, cyano, is unsubstituted or substituted with one or moresubstituents independently chosen from halogen, hydroxyl, amino,C₁-C₂alkyl, C₁-C₂alkoxy, —OSi(CH₃)₂C(CH₃)₃, —Si(CH₃)₂C(CH₃)₃,C₁-C₂haloalkyl, and C₁-C₂haloalkoxy.

In another embodiment, B is phenyl or pyridyl substituted with 1, 2, or3 substituents chosen from chloro, bromo, hydroxyl, —SCF₃, C₁-C₂alkyl,C₁-C₂alkoxy, trifluoromethyl, phenyl and trifluoromethoxy each of whichsubstituents other than chloro, bromo, hydroxyl, —SCF₃, can beoptionally substituted.

In certain embodiments, B is a 2-fluoro-3-chlorophenyl or a2-fluoro-3-trifluoromethoxyphenyl group.

In one embodiment, B is pyridyl, optionally substituted with halogen,C₁-C₂alkoxy, and trifluoromethyl.

In one embodiment, B is phenyl, substituted with 1, 2, or 3 substituentsindependently selected from halogen, C₁-C₂alkyl, C₁-C₂alkoxy,trifluoromethyl, and optionally substituted phenyl.

In one embodiment, R²³ is independently chosen at each occurrence from(C₃-C₇cycloalkyl)C₀-C₄alkyl, (phenyl)C₀-C₄alkyl, (4- to 7-memberedheterocycloalkyl)C₀-C₄alkyl having 1, 2, or 3 heteroatoms independentlychosen from N, O, and S, and (5- or 6-membered unsaturated or aromaticheterocycle)C₀-C₄alkyl having 1, 2, or 3 heteroatoms independentlychosen from N, O, and S.

In one embodiment, B is selected from:

where R²⁷ is hydrogen, methyl, or trifluoromethyl; R²⁸ is hydrogen orhalogen; and R²⁹ is hydrogen, methyl, trifluoromethyl, or—Si(CH₃)₂C(CH₃)₃.

Central Core (C═O)A Substituent

The central core (C═O)A substituent in Formula I is illustrated below:

A is a group chosen from:

R⁴ is chosen from —CHO, —CONH₂, C₂-C₆alkanoyl, hydrogen, —SO₂NH₂,—C(CH₂)₂F, —CH(CF₃)NH₂, C₁-C₆alkyl, —C₀-C₄alkyl(C₃-C₇cycloalkyl),—C(O)C₀-C₂alkyl(C₃-C₇cycloalkyl),

each of which R⁴ other than hydrogen, —CHO, and —CONH₂, is unsubstitutedor substituted with one or more of amino, imino, halogen, hydroxyl,cyano, cyanoimino, C₁-C₂alkyl, C₁-C₂alkoxy, —C₀-C₂alkyl(mono- anddi-C₁-C₄alkylamino), C₁-C₂haloalkyl, and C₁-C₂haloalkoxy.

R⁵ and R⁶ are independently chosen from —CHO, —C(O)NH₂, —C(O)NH(CH₃),C₂-C₆alkanoyl, hydrogen, hydroxyl, halogen, cyano, nitro, —COOH,—SO₂NH₂, vinyl, C₁-C₆alkyl (including methyl), C₂-C₆alkenyl,C₁-C₆alkoxy, —C₀-C₄alkyl(C₃-C₇cycloalkyl),—C(O)C₀-C₄alkyl(C₃-C₇cycloalkyl), —P(O)(OR⁹)₂, —OC(O)R⁹, —C(O)OR⁹,—C(O)N(CH₂CH₂R⁹)(™), —NR⁹C(O)R¹⁰, phenyl, or 5- to 6-memberedheteroaryl.

Each R⁵ and R⁶ other than hydrogen, hydroxyl, cyano, and —COOH isunsubstituted or optionally substituted. For example, R⁵ and R⁶ otherthan hydrogen, hydroxyl, cyano, and —COOH may be substituted with one ormore substituents independently chosen from halogen, hydroxyl, amino,imino, cyano, cyanoimino, C₁-C₂alkyl, C₁-C₄alkoxy, —C₀-C₂alkyl(mono- anddi-C₁-C₄alkylamino), C₁-C₂haloalkyl, and C₁-C₂haloalkoxy.

R^(6′) is hydrogen, halogen, hydroxyl, C₁-C₄alkyl,—C₀-C₄alkyl(C₃-C₇cycloalkyl), or C₁-C₄alkoxy; or R⁶ and R^(6′) may betaken together to form an oxo, vinyl, or imino group.

R⁷ is hydrogen, C₁-C₆alkyl, or —C₀-C₄alkyl(C₃-C₇cycloalkyl).

R⁸ and R^(8′) are independently chosen from hydrogen, halogen, hydroxyl,C₁-C₆alkyl, —C₀-C₄alkyl(C₃-C₇cycloalkyl), C₁-C₆alkoxy, and(C₁-C₄alkylamino)C₀-C₂alkyl; or R⁸ and R^(8′) are taken together to forman oxo group; or R⁸ and R^(8′) can be taken together with the carbonthat they are bonded to form a 3-membered carbocyclic ring.

R¹⁶ is absent or may include 1 or more substituents independently chosenfrom halogen, hydroxyl, nitro, cyano, C₁-C₆alkyl, C₂-C₆alkenyl,C₂-C₆alkanoyl, C₁-C₆alkoxy, —C₀-C₄alkyl(mono- and di-C₁-C₆alkylamino),—C₀-C₄alkyl(C₃-C₇cycloalkyl), C₁-C₂haloalkyl, and C₁-C₂haloalkoxy.

R¹⁹ is hydrogen, C₁-C₆alkyl, C₂-C₆alkenyl, C₂-C₆alkanoyl,—SO₂C₁-C₆alkyl, (mono- and di-C₁-C₆alkylamino)C₁-C₄alkyl,—C₀-C₄alkyl(C₃-C₇cycloalkyl), —C₀-C₄alkyl(C₃-C₇heterocycloalkyl),—C₀-C₄alkyl(aryl), C₀-C₄alkyl(heteroaryl), and wherein R¹⁹ other thanhydrogen is unsubstituted or substituted with 1 or more substituentsindependently chosen from halogen, hydroxyl, amino, —COOH, and—C(O)OC₁-C₄alkyl.

X¹¹ is N or CR¹¹.

X¹² is N or CR¹².

X¹³ is N or CR¹³.

X¹⁴ is N or CR¹⁴.

No more than 2 of X¹¹, X¹², X¹³, and X¹⁴ are N.

R¹¹, R¹⁴, and R¹⁵ are independently chosen at each occurrence fromhydrogen, halogen, hydroxyl, nitro, cyano, —O(PO)(OR⁹)₂, —(PO)(OR⁹)₂,C₁-C₆alkyl, C₂-C₆alkenyl, C₂-C₆alkynyl, C₂-C₆alkenyl(aryl),C₂-C₆alkenyl(cycloalkyl), C₂-C₆alkenyl(heterocycle),C₂-C₆alkenyl(heteroaryl), C₂-C₆alkynyl, C₂-C₆alkynyl(aryl),C₂-C₆alkynyl(cycloalkyl), C₂-C₆alkynyl(heterocycle),C₂-C₆alkynyl(heteroaryl), C₂-C₆alkanoyl, C₁-C₆alkoxy, C₁-C₆thioalkyl,—C₀-C₄alkyl(mono- and di-C₁-C₆alkylamino), —C₀-C₄alkyl(C₃-C₇cycloalkyl),—C₀-C₄alkoxy(C₃-C₇cycloalkyl), C₁-C₂haloalkyl, and C₁-C₂haloalkoxy.

In one embodiment, R⁵ and R⁶ are independently chosen from —CHO,—C(O)NH₂, —C(O)NH(CH₃), C₂-C₆alkanoyl, and hydrogen.

In one embodiment, each R⁵ and R⁶ other than hydrogen, hydroxyl, cyano,and —COOH is unsubstituted or substituted with one or more substituentsindependently chosen from halogen, hydroxyl, amino, imino, cyano,cyanoimino, C₁-C₂alkyl, C₁-C₄alkoxy, —C₀-C₂alkyl(mono- anddi-C₁-C₄alkylamino), C₁-C₂haloalkyl, and C₁-C₂haloalkoxy.

In one embodiment, R⁸ and R^(8′) are independently hydrogen or methyl.

In one embodiment, R⁸ and R^(8′) are hydrogen.

In one embodiment, R⁷ is hydrogen or methyl.

In one embodiment, R⁷ is hydrogen.

Embodiments of Formulas IA, IB, IC, and ID

To further illustrate the invention, various embodiments of Formula IA,IB, IC and ID are provided. These are presented by way of example toshow some of the variations among presented compounds within theinvention and can be applied to any of the Formulas I-XXX.

In one aspect, this disclosure includes compounds and salts of FormulaIA:

whereR⁶, R¹³, and B may carry any of the definitions set forth herein forthis variable.

In another aspect, this disclosure includes compounds and salts ofFormula IB, IC, and ID.

In Formulas IA, IB, IC, and ID, the variables may include any of thedefinitions set forth herein that results in a stable compound. Incertain embodiments, the following conditions apply for Formula IB andIC.

In some embodiments, structures are provided including Formulas IB andIC, wherein m=0, R¹ is H, R² is F, R⁶ is alkanoyl, R¹² is R³², R³² is—O(CH₂)₁₋₄P(O)R^(23b)R^(23b), R¹³ is H, and B is heteroaryl.

In some embodiments, structures are provided including Formulas IB andIC, wherein m=0, R¹ and R² are joined to form a 3 membered ring, R⁶ isalkanoyl, R¹² is R³², R³² is —O(CH₂)₁₋₄P(O)R^(23b)R^(23b), R¹³ is H, andB is heteroaryl.

In some embodiments, structures are provided including Formulas IB andIC, wherein m=0, R¹ is H, R² is F, R⁶ is amide, R¹² is R³², R³² is—O(CH₂)₁₋₄P(O)R^(23b)R^(23b), R¹³ is H, and B is heteroaryl.

In some embodiments, structures are provided including Formulas IB andIC, wherein m=0, R¹ and R² are joined to form a 3 membered ring, R⁶ isamide, R¹² is R³², R³² is —O(CH₂)₁₋₄P(O)R^(23b)R^(23b), R¹³ is H, and Bis heteroaryl.

In some embodiments, structures are provided including Formulas IB andIC, wherein m=0, R¹ is H, R² is F, R⁶ is alkanoyl, R¹² is H, R¹³ is R³²,R³² is —O(CH₂)₁₋₄P(O)R^(23b)R^(23b), and B is heteroaryl.

In some embodiments, structures are provided including Formulas IB andIC, wherein m=0, R¹ and R² are joined to form a 3 membered ring, R⁶ isalkanoyl, R¹² is H, R¹³ is R³², R³² is —O(CH₂)₁₋₄P(O)R^(23b)R^(23b), andB is heteroaryl.

In some embodiments, structures are provided including Formulas IB andIC, wherein m=0, R¹ is H, R² is F, R⁶ is amide, R¹² is H, R¹³ is R³²,R³² is —O(CH₂)₁₋₄P(O)R^(23b)R^(23b), and B is heteroaryl.

In some embodiments, structures are provided including Formulas IB andIC, wherein m=0, R¹ and R² are joined to form a 3 membered ring, R⁶ isamide, R¹² is H, R¹³ is R³², R³² is —O(CH₂)₁₋₄P(O)R^(23b)R^(23b), and Bis heteroaryl.

In some embodiments, structures are provided including Formulas IB andIC, wherein m=0, R¹ is H, R² is F, R⁶ is alkanoyl, R¹² is R³², R³² is—O(CH₂)₁₋₄P(O)R^(23b)R^(23b), R¹³ is H, and B is phenyl.

In some embodiments, structures are provided including Formulas IB andIC, wherein m=0, R¹ and R² are joined to form a 3 membered ring, R⁶ isalkanoyl, R¹² is R³², R³² is —O(CH₂)₁₋₄P(O)R^(23b)R^(23b), R¹³ is H, andB is phenyl.

In some embodiments, structures are provided including Formulas IB andIC, wherein m=0, R¹ is H, R² is F, R⁶ is amide, R¹² is R³², R³² is—O(CH₂)₁₋₄P(O)R^(23b)R^(23b), R¹³ is H, and B is phenyl.

In some embodiments, structures are provided including Formulas IB andIC, wherein m=0, R¹ and R² are joined to form a 3 membered ring, R⁶ isamide, R¹² is R³², R³² is —O(CH₂)₁₋₄P(O)R^(23b)R^(23b), R¹³ is H, and Bis phenyl.

In some embodiments, structures are provided including Formulas IB andIC, wherein m=0, R¹ is H, R² is F, R⁶ is alkanoyl, R¹² is H, R¹³ is R³²,R³² is —O(CH₂)₁₋₄P(O)R^(23b)R^(23b), and B is phenyl.

In some embodiments, structures are provided including Formulas IB andIC, wherein m=0, R¹ and R² are joined to form a 3 membered ring, R⁶ isalkanoyl, R¹² is H, R¹³ is R³², R³² is —O(CH₂)₁₋₄P(O)R^(23b)R^(23b), andB is phenyl.

In some embodiments, structures are provided including Formulas IB andIC, wherein m=0, R¹ is H, R² is F, R⁶ is amide, R¹² is H, R¹³ is R³²,R³² is —O(CH₂)₁₋₄P(O)R^(23b)R^(23b), and B is phenyl.

In some embodiments, structures are provided including Formulas IB andIC, wherein m=0, R¹ and R² are joined to form a 3 membered ring, R⁶ isamide, R¹² is H, R¹³ is R³², R³² is —O(CH₂)₁₋₄P(O)R^(23b)R^(23b), and Bis phenyl.

In some embodiments, structures are provided including Formulas IB andIC, wherein m=1, R¹ is H, R² is F, R⁶ is alkanoyl, R¹² is R³², R³² is—O(CH₂)₁₋₄P(O)R^(23b)R^(23b), R¹³ is H, and B is heteroaryl.

In some embodiments, structures are provided including Formulas IB andIC, wherein m=1, R¹ and R² are joined to form a 3 membered ring, R⁶ isalkanoyl, R¹² is R³², R³² is —O(CH₂)₁₋₄P(O)R^(23b)R^(23b), R¹³ is H, andB is heteroaryl.

In some embodiments, structures are provided including Formulas IB andIC, wherein m=1, R¹ is H, R² is F, R⁶ is amide, R¹² is R³², R³² is—O(CH₂)₁₋₄P(O)R^(23b)R^(23b), R¹³ is H, and B is heteroaryl.

In some embodiments, structures are provided including Formulas IB andIC, wherein m=1, R¹ and R² are joined to form a 3 membered ring, R⁶ isamide, R¹² is R³², R³² is —O(CH₂)₁₋₄P(O)R^(23b)R^(23b), R¹³ is H, and Bis heteroaryl.

In some embodiments, structures are provided including Formulas IB andIC, wherein m=1, R¹ is H, R² is F, R⁶ is alkanoyl, R¹² is H, R¹³ is R³²,R³² is —O(CH₂)₁₋₄P(O)R^(23b)R^(23b), and B is heteroaryl.

In some embodiments, structures are provided including Formulas IB andIC, wherein m=1, R¹ and R² are joined to form a 3 membered ring, R⁶ isalkanoyl, R¹² is H, R¹³ is R³², R³² is —O(CH₂)₁₋₄P(O)R^(23b)R^(23b), andB is heteroaryl.

In some embodiments, structures are provided including Formulas IB andIC, wherein m=1, R¹ is H, R² is F, R⁶ is amide, R¹² is H, R¹³ is R³²,R³² is —O(CH₂)₁₋₄P(O)R^(23b)R^(23b), and B is heteroaryl.

In some embodiments, structures are provided including Formulas IB andIC, wherein m=1, R¹ and R² are joined to form a 3 membered ring, R⁶ isamide, R¹² is H, R¹³ is R³², R³² is —O(CH₂)₁₋₄P(O)R^(23b)R^(23b), and Bis heteroaryl.

In some embodiments, structures are provided including Formulas IB andIC, wherein m=1, R¹ is H, R² is F, R⁶ is alkanoyl, R¹² is R³², R³² is—O(CH₂)₁₋₄P(O)R^(23b)R^(23b), R¹³ is H, and B is phenyl.

In some embodiments, structures are provided including Formulas IB andIC, wherein m=1, R¹ and R² are joined to form a 3 membered ring, R⁶ isalkanoyl, R¹² is R³², R³² is —O(CH₂)₁₋₄P(O)R^(23b)R^(23b), R¹³ is H, andB is phenyl.

In some embodiments, structures are provided including Formulas IB andIC, wherein m=1, R¹ is H, R² is F, R⁶ is amide, R¹² is R³², R³² is—O(CH₂)₁₋₄P(O)R^(23b)R^(23b), R¹³ is H, and B is phenyl.

In some embodiments, structures are provided including Formulas IB andIC, wherein m=1, R¹ and R² are joined to form a 3 membered ring, R⁶ isamide, R¹² is R³², R³² is —O(CH₂)₁₋₄P(O)R^(23b)R^(23b), R¹³ is H, and Bis phenyl.

In some embodiments, structures are provided including Formulas IB andIC, wherein m=1, R¹ is H, R² is F, R⁶ is alkanoyl, R¹² is H, R¹³ is R³²,R³² is —O(CH₂)₁₋₄P(O)R^(23b)R^(23b), and B is phenyl.

In some embodiments, structures are provided including Formulas IB andIC, wherein m=1, R¹ and R² are joined to form a 3 membered ring, R⁶ isalkanoyl, R¹² is H, R¹³ is R³², R³² is —O(CH₂)₁₋₄P(O)R^(23b)R^(23b), andB is phenyl.

In some embodiments, structures are provided including Formulas IB andIC, wherein m=1, R¹ is H, R² is F, R⁶ is amide, R¹² is H, R¹³ is R³²,R³² is —O(CH₂)₁₋₄P(O)R^(23b)R^(23b), and B is phenyl.

In some embodiments, structures are provided including Formulas IB andIC, wherein m=1, R¹ and R² are joined to form a 3 membered ring, R⁶ isamide, R¹² is H, R¹³ is R³², R³² is —O(CH₂)₁₋₄P(O)R^(23b)R^(23b), and Bis phenyl.

In the above embodiments, structures are provided including Formulas IBand IC, wherein;

R^(23b) is independently chosen at each occurrence from hydroxyl,C₁-C₆alkoxy, C₁-C₆alkyl, (C₃-C₇cycloalkyl)C₀-C₄alkyl,(phenyl)C₀-C₄alkyl, —O(CH₂)₂₋₄O(CH₂)₈₋₁₈, —OC(R^(23c))₂OC(O)OR^(23d),—OC(R^(23c))₂OC(O)R^(23d), an N-linked amino acid or an N-linked aminoacid ester, and each R^(23b) can be optionally substituted;

R^(23c) is independently chosen at each occurrence from hydrogen,C₁-C₈alkyl, C₂-C₈alkenyl, C₂-C₈alkynyl, (aryl)C₀-C₄alkyl,(aryl)C₂-C₈alkenyl- or (aryl)C₂-C₈alkynyl; or two R^(23c) groups can betaken together with the carbon that they are bonded to form a 3-6membered heterocycloalkyl having 1, 2, or 3 heteroatoms independentlychosen from N, O, and S, or a 3-6 membered carbocyclic ring, and eachR^(23c) can be optionally substituted;

R^(23d) is independently chosen at each occurrence from C₁-C₈alkyl,C₂-C₈alkenyl, C₂-C₈alkynyl, (aryl)C₀-C₄alkyl, (aryl)C₂-C₈alkenyl or(aryl)C₂-C₈alkynyl, and each R^(23d) can be optionally substituted.

Embodiments of Formula VII

To further illustrate the invention, various embodiments of Formula VII.In one aspect, the disclosure includes compounds and salts of FormulaVII:

wherein:

R¹, R², R^(2′), and R³ are independently chosen from hydrogen, halogen,C₁-C₄alkyl, C₁-C₄alkoxy, —C₀-C₂alkylNR⁹R¹⁰,—C₀-C₄alkyl(C₃-C₇cycloalkyl), —O—C₀-C₄alkyl(C₃-C₇cycloalkyl),C₁-C₂haloalkyl, and C₁-C₂haloalkoxy;

R⁸ and R^(8′) are independently chosen from hydrogen, halogen, andmethyl;

R⁵ is hydrogen, hydroxyl, cyano, —COOH, C₁-C₆alkyl, C₁-C₆alkoxy,C₂-C₆alkanoyl —C₀-C₄alkyl(C₃-C₇cycloalkyl),—C(O)C₀-C₄alkyl(C₃-C₇cycloalkyl, C₁-C₂haloalkyl, or C₁-C₂haloalkoxy;

R⁶ is —C(O)CH₃, —C(O)NH₂, —C(O)CF₃, —C(O)(cyclopropyl), or-ethyl(cyanoimino); and

R¹¹ and R¹⁴ are independently chosen from hydrogen, halogen, hydroxyl,amino, nitro, cyano, C₁-C₆alkyl, C₂-C₆alkenyl, C₂-C₆alkanoyl,C₁-C₆alkoxy, C₁-C₆thioalkyl, —C₀-C₄alkyl(mono- and di-C₁-C₆alkylamino),—C₀-C₄alkyl(C₃-C₇cycloalkyl), —OC₀-C₄alkyl(C₃-C₇cycloalkyl),C₁-C₂haloalkyl, and C₁-C₂haloalkoxy.

III. Pharmaceutical Preparations

Compounds disclosed herein can be administered as the neat chemical, butcan also administered as a pharmaceutical composition, that includes aneffective amount for a host in need of treatment of the selectedcompound of Formula I, as described herein. Accordingly, the disclosureprovides pharmaceutical compositions comprising an effective amount ofcompound or pharmaceutically acceptable salt of Formula I, together withat least one pharmaceutically acceptable carrier. The pharmaceuticalcomposition may contain a compound or salt of Formula I as the onlyactive agent, or, in an alternative embodiment, Formula I and at leastone additional active agent. In certain embodiments the pharmaceuticalcomposition is in a dosage form that contains from about 0.1 mg to about2000 mg, from about 10 mg to about 1000 mg, from about 100 mg to about800 mg, or from about 200 mg to about 600 mg of a compound of Formula Iand optionally from about 0.1 mg to about 2000 mg, from about 10 mg toabout 1000 mg, from about 100 mg to about 800 mg, or from about 200 mgto about 600 mg of an additional active agent in a unit dosage form.Examples are dosage forms with at least 25, 50, 100, 200, 250, 300, 400,500, 600, 700, or 750 mg of active compound, or its salt. Thepharmaceutical composition may also include a molar ratio of a compoundof Formula I and an additional active agent. For example thepharmaceutical composition may contain a molar ratio of about 0.5:1,about 1:1, about 2:1, about 3:1 or from about 1.5:1 to about 4:1 of ananother anti-inflammatory agent.

Compounds disclosed herein may be administered orally, topically,parenterally, by inhalation or spray, sublingually, via implant,including ocular implant, transdermally, via buccal administration,rectally, as an ophthalmic solution, injection, including ocularinjection, intravenous, intra-aortal, intracranial, or by other means,in dosage unit formulations containing conventional pharmaceuticallyacceptable carriers. The pharmaceutical composition may be formulated asany pharmaceutically useful form, e.g., as an aerosol, a cream, a gel, apill, a capsule, a tablet, a syrup, a transdermal patch, or anophthalmic solution. Some dosage forms, such as tablets and capsules,are subdivided into suitably sized unit closes containing appropriatequantities of the active components, e.g., an effective amount toachieve the desired purpose.

Carriers include excipients and diluents and must be of sufficientlyhigh purity and sufficiently low toxicity to render them suitable foradministration to the patient being treated. The carrier can be inert orit can possess pharmaceutical benefits of its own. The amount of carrieremployed in conjunction with the compound is sufficient to provide apractical quantity of material for administration per unit close of thecompound.

Classes of carriers include, but are not limited to binders, bufferingagents, coloring agents, diluents, disintegrants, emulsifiers,flavorants, glidents, lubricants, preservatives, stabilizers,surfactants, tableting agents, and wetting agents. Some carriers may belisted in more than one class, for example vegetable oil may be used asa lubricant in some formulations and a diluent in others. Exemplarypharmaceutically acceptable carriers include sugars, starches,celluloses, powdered tragacanth, malt, gelatin; talc, and vegetableoils. Optional active agents may be included in a pharmaceuticalcomposition, which do not substantially interfere with the activity ofthe compound of the present invention.

The pharmaceutical compositions/combinations can be formulated for oraladministration. These compositions can contain any amount of activecompound for Formula I that achieves the desired result, for examplebetween 0.1 and 99 weight % (wt. %) of a compound of Formula I andusually at least about 5 wt. % of a compound of Formula I. Someembodiments contain from about 25 wt. % to about 50 wt. % or from about5 wt. % to about 75 wt. % of the compound of Formula I.

The complement factor D inhibitors of the present invention can beadministered, for example, either systemically or locally. Systemicadministration includes, for example, oral, transdermal, subdermal,intraperitioneal, subcutaneous, transnasal, sublingual, or rectal. Localadministration for ocular administration includes: topical,intravitreal, periocular, transscleral, retrobulbar, juxtascleral,sub-tenon, or via an intraocular device. The inhibitors may be deliveredvia a sustained delivery device implanted intravitreally ortranssclerally, or by other known means of local ocular delivery.

IV. Methods of Treatment

The compounds and pharmaceutical compositions disclosed herein areuseful for treating or preventing an inflammatory disorder or complementrelated disease in patients. Inflammatory disorders or complementrelated diseases that may be treated or prevented by the compounds andcompositions of this disclosure include, but are not limited to,inflammatory effects of sepsis, systemic inflammatory response syndrome(SIRS), ischemia/reperfusion injury (I/R injury), psoriasis, myastheniagravis, system lupus erythematosus (SLE), paroxysmal nocturnalhemoglobinuria (PNH), hereditary angioedema, multiple sclerosis, trauma,burn injury, capillary leak syndrome, obesity, diabetes, Alzheimer'sdementia, stroke, schizophrenia, epilepsy, age-related maculardegeneration, glaucoma, diabetic retinopathy, asthma, allergy, acuterespiratory distress syndrome (ARDS), atypical hemolytic uremic syndrome(aHUS), hemolytic uremic syndrome (HUS), cystic fibrosis, myocardialinfarction, lupus nephritides, Crohn's disease, rheumatoid arthritis,atherosclerosis, transplant rejection, prevention of fetal loss,biomaterial reactions (e.g. in hemodialysis, inplants), C3glomerulonephritis, abdominal aortic aneurysm, neuromyelitis optica(NMO), vasculitis, neurological disorders, Guillain Barre Syndrome,traumatic brain injury, Parkinson's disease, disorders of inappropriateor undesirable complement activation, hemodialysis complications,hyperacute allograft rejection, xenograft rejection, interleukin-2induced toxicity during I L−2 therapy, inflammatory disorders,inflammation of autoimmune diseases, adult respiratory distresssyndrome, thermal injury including burns or frostbite, myocarditis,post-ischemic reperfusion conditions, balloon angioplasty, post-pumpsyndrome in cardiopulmonary bypass or renal bypass, hemodialysis, renalischemia, mesenteric artery reperfusion after aortic reconstruction,immune complex disorders and autoimmune diseases, SLE nephritis,proliferative nephritis, liver fibrosis, hemolytic anemia, tissueregeneration and neural regeneration. In addition, other knowncomplement related disease are lung disease and disorders such asdyspnea, hemoptysis, chronic obstructive pulmonary disease (COPD),emphysema, pulmonary embolisms and infarcts, pneumonia, fibrogenic dustdiseases, inert dusts and minerals (e.g., silicon, coal dust, beryllium,and asbestos), pulmonary fibrosis, organic dust diseases, chemicalinjury (due to irritant gases and chemicals, e.g., chlorine, phosgene,sulfur dioxide, hydrogen sulfide, nitrogen dioxide, ammonia, andhydrochloric acid), smoke injury, thermal injury (e.g., burn, freeze),bronchoconstriction, hypersensitivity pneumonitis, parasitic diseases,Goodpasture's Syndrome, pulmonary vasculitis, Pauci-immune vasculitis,immune complex-associated inflammation, uveitis (including Behcet'sdisease and other sub-types of uveitis), antiphospholipid syndrome,arthritis, autoimmune heart disease, inflammatory bowel disease,ischemia-reperfusion injuries, Barraquer-Simons Syndrome, hemodialysis,systemic lupus, lupus erythematosus, transplantation, diseases of thecentral nervous system and other neurodegenerative conditions,glomerulonephritis (including membrane proliferativeglomerulonephritis), blistering cutaneous diseases (including bullouspemphigoid, pemphigus, and epidermolysis bullosa), ocular cicatricalpemphigoid, MPGN II, uveitis, adult macular degeneration, diabeticretinopathy, retinitis pigmentosa, macular edema, Behcet's uveitis,multifocal choroiditis, Vogt-Koyangi-Harada syndrome, imtermediateuveitis, birdshot retino-chorioditis, sympathetic ophthalmia, oculardicatricial pemphigoid, ocular pemphigus, nonartertic ischemic opticneuropathy, postoperative inflammation, and retinal vein occlusion.

In one embodiment, a method for the treatment of paroxysmal nocturnalhemoglobinuria (PNH) is provided that includes the administration of aneffective amount of a compound of Formula I, or a pharmaceuticallyacceptable salt thereof, optionally in a pharmaceutically acceptablecarrier. In another embodiment, a method for the treatment ofage-related macular degeneration (AMD) is provided that includes theadministration of an effective amount of a compound of Formula I, or apharmaceutically acceptable salt thereof, optionally in apharmaceutically acceptable carrier. In another embodiment, a method forthe treatment of rheumatoid arthritis is provided that includes theadministration of an effective amount of a compound of Formula I, or apharmaceutically acceptable salt thereof, optionally in apharmaceutically acceptable carrier. In another embodiment, a method forthe treatment of multiple sclerosis is provided that includes theadministration of an effective amount of a compound of Formula I, or apharmaceutically acceptable salt thereof, optionally in apharmaceutically acceptable carrier. In another embodiment, a method forthe treatment of myasthenia gravis is provided that includes theadministration of an effective amount of a compound of Formula I, or apharmaceutically acceptable salt thereof, optionally in apharmaceutically acceptable carrier. In another embodiment, a method forthe treatment of atypical hemolytic uremic syndrome (aHUS) is providedthat includes the administration of an effective amount of a compound ofFormula I, or a pharmaceutically acceptable salt thereof, optionally ina pharmaceutically acceptable carrier. In another embodiment, a methodfor the treatment of C3 glomerulonephritis is provided that includes theadministration of an effective amount of a compound of Formula I, or apharmaceutically acceptable salt thereof, optionally in apharmaceutically acceptable carrier. In another embodiment, a method forthe treatment of abdominal aortic aneurysm is provided that includes theadministration of an effective amount of a compound of Formula I, or apharmaceutically acceptable salt thereof, optionally in apharmaceutically acceptable carrier. In another embodiment, a method forthe treatment of neuromyelitis optica (NMO) is provided that includesthe administration of an effective amount of a compound of Formula I, ora pharmaceutically acceptable salt thereof, optionally in apharmaceutically acceptable carrier.

In some embodiments, the present invention provides methods of treatingor preventing an inflammatory disorder or a complement related disease,by administering to a subject in need thereof an effective amount of thecompound of Formula I of the invention. In some embodiments, the presentinvention provides methods of treating or preventing an inflammatorydisorder or a complement related disease, by providing an effectiveamount of a compound or pharmaceutically acceptable salt of Formula I topatient with a Factor D mediated inflammatory disorder. A compound orsalt of Formula I may be provided as the only active agent or may beprovided together with one or more additional active agents.

In one embodiment, a method for the treatment of a disorder associatedwith a defect in the complement cascade is provided that includes theadministration of an effective amount of a compound of Formula I, or apharmaceutically acceptable salt thereof, optionally in apharmaceutically acceptable carrier. In one embodiment, a method ofinhibiting activation of the alternative complement pathway in a subjectis provided that includes the administration of an effective amount of acompound of Formula I, or a pharmaceutically acceptable salt thereof,optionally in a pharmaceutically acceptable carrier. In one embodiment,a method of modulating Factor D activity in a subject is provided thatincludes the administration of an effective amount of a compound ofFormula I, or a pharmaceutically acceptable salt thereof, optionally ina pharmaceutically acceptable carrier.

“Prevention” as used in this disclosure means decreasing the likelihoodof the appearance of symptoms in a patient administered the compoundprophylactically as compared to the likelihood of the appearance ofsymptoms in patients not administered the compound or decreasing theseverity of symptoms in a patient administered the compoundprophylactically as compared to the severity of symptoms experienced bypatients with the disorder or condition who were not administered thecompound.

An effective amount of a pharmaceutical composition/combination of theinvention may be an amount sufficient to (a) inhibit the progression ofan inflammatory disorder or a complement related disease; (b) cause aregression of the inflammatory disorder or complement related disease;or (c) cause a cure of an inflammatory disorder or a complement relateddisease.

An effective amount of a compound or pharmaceutical compositiondescribed herein will also provide a sufficient concentration of theactive agent when administered to a patient to provide a clinicalbenefit. Such an amount may be ascertained experimentally, for exampleby assaying blood concentration of the agent, or theoretically, bycalculating bioavailability. The amount of an active agent sufficient toinhibit an inflammatory disorder may be determined with a conventionalassay for Complement Factor D inhibition.

V. Combination Therapy

The compounds and pharmaceutical compositions disclosed herein areuseful for treating or preventing a disorder that is mediated by thecomplement pathway, and in particular, a pathway that is modulated bycomplement factor D. In certain embodiments, the disorder is aninflammatory disorder, an immune disorder, an autoimmune disorder, orcomplement factor D related disorders in a host. In one embodiment, thedisorder is an ocular disorder. Complement mediated disorders that maybe treated or prevented by the compounds and compositions of thisdisclosure include, but are not limited to, inflammatory effects ofsepsis, systemic inflammatory response syndrome (SIRS),ischemia/reperfusion injury (I/R injury), psoriasis, myasthenia gravis,system lupus erythematosus (SLE), paroxysmal nocturnal hemoglobinuria(PNH), hereditary angioedema, multiple sclerosis, trauma, burn injury,capillary leak syndrome, obesity, diabetes, Alzheimer's dementia,stroke, schizophrenia, epilepsy, age-related macular degeneration,glaucoma, diabetic retinopathy, asthma, allergy, acute respiratorydistress syndrome (ARDS), atypical hemolytic uremic syndrome (aHUS),hemolytic uremic syndrome (HUS), cystic fibrosis, myocardial infarction,lupus nephritides, Crohn's disease, rheumatoid arthritis,atherosclerosis, transplant rejection, prevention of fetal loss,biomaterial reactions (e.g. in hemodialysis, inplants), C3glomerulonephritis, abdominal aortic aneurysm, neuromyelitis optica(NMO), vasculitis, neurological disorders, Guillain Barre Syndrome,traumatic brain injury, Parkinson's disease, disorders of inappropriateor undesirable complement activation, hemodialysis complications,hyperacute allograft rejection, xenograft rejection, interleukin-2induced toxicity during I L−2 therapy, inflammatory disorders,inflammation of autoimmune diseases, adult respiratory distresssyndrome, thermal injury including burns or frostbite, myocarditis,post-ischemic reperfusion conditions, balloon angioplasty, post-pumpsyndrome in cardiopulmonary bypass or renal bypass, hemodialysis, renalischemia, mesenteric artery reperfusion after aortic reconstruction,immune complex disorders and autoimmune diseases, SLE nephritis,proliferative nephritis, liver fibrosis, hemolytic anemia, tissueregeneration and neural regeneration. In addition, other knowncomplement related disease are lung disease and disorders such asdyspnea, hemoptysis, chronic obstructive pulmonary disease (COPD),emphysema, pulmonary embolisms and infarcts, pneumonia, fibrogenic dustdiseases, inert dusts and minerals (e.g., silicon, coal dust, beryllium,and asbestos), pulmonary fibrosis, organic dust diseases, chemicalinjury (due to irritant gases and chemicals, e.g., chlorine, phosgene,sulfur dioxide, hydrogen sulfide, nitrogen dioxide, ammonia, andhydrochloric acid), smoke injury, thermal injury (e.g., burn, freeze),bronchoconstriction, hypersensitivity pneumonitis, parasitic diseases,Goodpasture's Syndrome, pulmonary vasculitis, Pauci-immune vasculitis,immune complex-associated inflammation, uveitis (including Behcet'sdisease and other sub-types of uveitis), antiphospholipid syndrome,arthritis, autoimmune heart disease, inflammatory bowel disease,ischemia-reperfusion injuries, Barraquer-Simons Syndrome, hemodialysis,systemic lupus, lupus erythematosus, transplantation, diseases of thecentral nervous system and other neurodegenerative conditions,glomerulonephritis (including membrane proliferativeglomerulonephritis), blistering cutaneous diseases (including bullouspemphigoid, pemphigus, and epidermolysis bullosa), ocular cicatricalpemphigoid, MPGN II, uveitis, adult macular degeneration, diabeticretinopathy, retinitis pigmentosa, macular edema, Behcet's uveitis,multifocal choroiditis, Vogt-Koyangi-Harada syndrome, imtermediateuveitis, birdshot retino-chorioditis, sympathetic ophthalmia, oculardicatricial pemphigoid, ocular pemphigus, nonartertic ischemic opticneuropathy, postoperative inflammation, and retinal vein occlusion.

In some embodiments, complement mediated diseases include ophthalmicdiseases (including early or neovascular age-related maculardegeneration and geographic atrophy), autoimmune diseases (includingarthritis, rheumatoid arthritis), respiratory diseases, cardiovasculardiseases. In other embodiments, the compounds of the invention aresuitable for use in the treatment of diseases and disorders associatedwith fatty acid metabolism, including obesity and other metabolicdisorders.

In one embodiment, a method for the treatment of paroxysmal nocturnalhemoglobinuria (PNH) is provided that includes the administration of aneffective amount of a compound of Formula I, or a pharmaceuticallyacceptable salt thereof, optionally in a pharmaceutically acceptablecarrier. In another embodiment, a method for the treatment ofage-related macular degeneration (AMD) is provided that includes theadministration of an effective amount of a compound of Formula I, or apharmaceutically acceptable salt thereof, optionally in apharmaceutically acceptable carrier. In another embodiment, a method forthe treatment of rheumatoid arthritis is provided that includes theadministration of an effective amount of a compound of Formula I, or apharmaceutically acceptable salt thereof, optionally in apharmaceutically acceptable carrier. In another embodiment, a method forthe treatment of multiple sclerosis is provided that includes theadministration of an effective amount of a compound of Formula I, or apharmaceutically acceptable salt thereof, optionally in apharmaceutically acceptable carrier. In another embodiment, a method forthe treatment of myasthenia gravis is provided that includes theadministration of an effective amount of a compound of Formula I, or apharmaceutically acceptable salt thereof, optionally in apharmaceutically acceptable carrier. In another embodiment, a method forthe treatment of atypical hemolytic uremic syndrome (aHUS) is providedthat includes the administration of an effective amount of a compound ofFormula I, or a pharmaceutically acceptable salt thereof, optionally ina pharmaceutically acceptable carrier. In another embodiment, a methodfor the treatment of C3 glomerulonephritis is provided that includes theadministration of an effective amount of a compound of Formula I, or apharmaceutically acceptable salt thereof, optionally in apharmaceutically acceptable carrier. In another embodiment, a method forthe treatment of abdominal aortic aneurysm is provided that includes theadministration of an effective amount of a compound of Formula I, or apharmaceutically acceptable salt thereof, optionally in apharmaceutically acceptable carrier. In another embodiment, a method forthe treatment of neuromyelitis optica (NMO) is provided that includesthe administration of an effective amount of a compound of Formula I, ora pharmaceutically acceptable salt thereof, optionally in apharmaceutically acceptable carrier.

In some embodiments, the present invention provides methods of treatingor preventing an inflammatory disorder or a complement related disease,by administering to a host in need thereof an effective amount of acompound of Formula I of the invention. In some embodiments, the presentinvention provides methods of treating or preventing an inflammatorydisorder more generally, an immune disorder, autoimmune disorder, orcomplement factor D related disease, by providing an effective amount ofa compound or pharmaceutically acceptable salt of Formula I to patientwith a factor D mediated inflammatory disorder. A compound or salt ofFormula I may be provided as the only active agent or may be providedtogether with one or more additional active agents.

In one embodiment, a method for the treatment of a disorder associatedwith a dysfunction in the complement cascade is provided that includesthe administration of an effective amount of a compound of Formula I, ora pharmaceutically acceptable salt thereof, optionally in apharmaceutically acceptable carrier. In one embodiment, a method ofinhibiting activation of the alternative complement pathway in a subjectis provided that includes the administration of an effective amount of acompound of Formula I, or a pharmaceutically acceptable salt thereof,optionally in a pharmaceutically acceptable carrier. In one embodiment,a method of modulating factor D activity in a subject is provided thatincludes the administration of an effective amount of a compound ofFormula I, or a pharmaceutically acceptable salt thereof, optionally ina pharmaceutically acceptable carrier.

“Prevention” as used in this disclosure means decreasing the likelihoodof the appearance of symptoms in a patient administered the compoundprophylactically as compared to the likelihood of the appearance ofsymptoms in patients not administered the compound or decreasing theseverity of symptoms in a patient administered the compoundprophylactically as compared to the severity of symptoms experienced bypatients with the disorder or condition who were not administered thecompound. In an alternative embodiment, an effective amount of acompound of Formula I is used to prevent or prophylaxis of a complementfactor D related disorder.

An effective amount of a pharmaceutical composition/combination of theinvention may be an amount sufficient to (a) inhibit the progression ofa disorder mediated by the complement pathway, including aninflammatory, immune, including an autoimmune, disorder or complementfactor D related disease; (b) cause a regression of an inflammatory,immune, including an autoimmune, disorder or complement factor D relateddisease; or (c) cause a cure of an inflammatory, immune, including anautoimmune, disorder or complement factor D related disease.

An effective amount of a compound or pharmaceutical compositiondescribed herein will also provide a sufficient amount of the activeagent when administered to a patient to provide a clinical benefit. Suchan amount may be ascertained experimentally, for example by assayingblood concentration of the agent, or theoretically, by calculatingbioavailability.

VI. Combination Therapy

In one embodiment, a compound or salt of Formula I may be provided incombination or alternation with at least one additional inhibitor of thecomplement system or a second active compound with a differentbiological mechanism of action. In one embodiment, a compound or salt ofFormula I may be provided in combination with a complement C5 inhibitoror C5 convertase inhibitor. In another embodiment, a compound or salt ofFormula I may be provided in combination with eculizumab. In oneembodiment, a compound or salt of Formula I may be provided incombination with additional inhibitors of factor D.

In one embodiment, a compound or salt of Formula I may be providedtogether with a compound that inhibits an enzyme that metabolizesprotease inhibitors. In one embodiment, a compound or salt of Formula Imay be provided together with ritonavir.

In nonlimiting embodiments, a compound or salt of Formula I may beprovided together with a protease inhibitor, a soluble complementregulator, a therapeutic antibody (monoclonal or polyclonal), complementcomponent inhibitors, receptor agonists, or siRNAs.

Nonlimiting examples of active agents in these categories are:

Protease inhibitors: plasma-derived C₁—INH concentrates, for exampleCetor® (Sanquin), Berinert-α® (CSL Behring, Lev Pharma), and Cinryze®;and recombinant human C₁-inhibitors, for example Rhucin®;

Soluble complement regulators: Soluble complement receptor 1 (TP10)(Avant Immunotherapeutics); sCR1-sLex/TP-20 (Avant Immunotherapeutics);MLN-2222/CAB-2 (Millenium Pharmaceuticals); Mirococept (InflazymePharmaceuticals);

Therapeutic antibodies: Eculizumab/Soliris® (Alexion Pharmaceuticals);Pexelizumab (Alexion Pharmaceuticals); Ofatumumab (Genmab A/S); TNX-234(Tanox); TNX-558 (Tanox); TA106 (Taligen Therapeutics); Neutrazumab (G2Therapies); Anti-properdin (Novelmed Therapeutics); HuMax-CD38 (GenmabA/S);

Complement component inhibitors: Compstatin/POT-4 (PotentiaPharmaceuticals); ARC 1905 (Archemix);

Receptor agonists: PMX-53 (Peptech Ltd.); JPE-137 (Jerini); JSM-7717(Jerini);

Others: Recombinant human MBL (rhMBL; Enzon Pharmaceuticals).

In an embodiment, the present invention provides a method of treating orpreventing age-related macular degeneration (AMD) by administering to asubject in need thereof an effective amount of a composition comprisinga compound of the current invention. In one embodiment, the compositionsof the present invention are administered in combination with ananti-VEGF agent. Nonlimiting examples of anti-VEGF agents include, butare not limited to, aflibercept (Eylea®; Regeneron Pharmaceuticals);ranibizumab (Lucentis®: Genentech and Novartis); and pegaptanib(Macugen®; OSI Pharmaceuticals and Pfizer); Bevacizumab (Avastin;Genentech/Roche); anecortane acetate, squalamine lactate, andcorticosteroids, including, but not limited to, triamcinolone acetonide.

In another embodiment, a compound of Formula I can be combined with asecond agent in order to treat a disorder of the eye.

Examples of types of therapeutic agents that can be used in combinationfor ocular applications include anti-inflammatory drugs, antimicrobialagents, anti-angiogenesis agents, immunosuppressants, antibodies,steroids, ocular antihypertensive drugs and combinations thereof.Examples of therapeutic agents include amikacin, anecortane acetate,anthracenedione, anthracycline, an azole, amphotericin B, bevacizumab,camptothecin, cefuroxime, chloramphenicol, chlorhexidine, chlorhexidinedigluconate, clortrimazole, a clotrimazole cephalosporin,corticosteroids, dexamethasone, desamethazone, econazole, eftazidime,epipodophyllotoxin, fluconazole, flucytosine, fluoropyrimidines,fluoroquinolines, gatifloxacin, glycopeptides, imidazoles, itraconazole,ivermectin, ketoconazole, levofloxacin, macrolides, miconazole,miconazole nitrate, moxifloxacin, natamycin, neomycin, nystatin,ofloxacin, polyhexamethylene biguanide, prednisolone, prednisoloneacetate, pegaptanib, platinum analogues, polymicin B, propamidineisethionate, pyrimidine nucleoside, ranibizumab, squalamine lactate,sulfonamides, triamcinolone, triamcinolone acetonide, triazoles,vancomycin, anti-vascular endothelial growth factor (VEGF) agents, VEGFantibodies, VEGF antibody fragments, vinca alkaloid, timolol, betaxolol,travoprost, latanoprost, bimatoprost, brimonidine, dorzolamide,acetazolamide, pilocarpine, ciprofloxacin, azithromycin, gentamycin,tobramycin, cefazolin, voriconazole, gancyclovir, cidofovir, foscarnet,diclofenac, nepafenac, ketorolac, ibuprofen, indomethacin,fluoromethalone, rimexolone, anecortave, cyclosporine, methotrexate,tacrolimus and combinations thereof. Examples of eye disorders that maybe treated according to the compositions and methods disclosed hereininclude amoebic keratitis, fungal keratitis, bacterial keratitis, viralkeratitis, onchorcercal keratitis, bacterial keratoconjunctivitis, viralkeratoconjunctivitis, corneal dystrophic diseases, Fuchs' endothelialdystrophy, Sjögren's syndrome, Stevens-Johnson syndrome, autoimmune dryeye diseases, environmental dry eye diseases, corneal neovascularizationdiseases, post-corneal transplant rejection prophylaxis and treatment,autoimmune uveitis, infectious uveitis, anterior uveitis, posterioruveitis (including toxoplasmosis), pan-uveitis, an inflammatory diseaseof the vitreous or retina, endophthalmitis prophylaxis and treatment,macular edema, macular degeneration, age related macular degeneration,proliferative and non-proliferative diabetic retinopathy, hypertensiveretinopathy, an autoimmune disease of the retina, primary and metastaticintraocular melanoma, other intraocular metastatic tumors, open angleglaucoma, closed angle glaucoma, pigmentary glaucoma and combinationsthereof.

A compound of Formula I, or a combination of Formula I and anotheractive agent, can be administered into an eye compartment of viainjection into the vitreous chamber, subretinal space, subchoroidalspace, the episclera, the conjunctiva, the sclera, the anterior chamber,and the cornea and compartments therein (e.g., subepithelial,intrastromal, endothelial).

In an alternative embodiment, a compound of Formula I, or a combinationof Formula I and another active agent, can be administered into an eyecompartment via binding to a mucosal penetrating particle to treat acondition located in the vitreous chamber, subretinal space,subchoroidal space, the episclera, the conjunctiva, the sclera or theanterior chamber, and the cornea and compartments therein (e.g.,subepithelial, intrastromal, endothelial). Mucosal penetrating particlesare known in the art, and are described in, for example, PCT publishedapplication WO 2013166436 to Kala Pharmaceuticals, incorporated in itsentirety herein.

In other embodiments, a composition comprising compound of Formula Isuitable for topical administration to an eye is provided. Thepharmaceutical composition comprises a plurality of coated particles,comprising a core particle comprising a compound of Formula I, whereinFormula I constitutes at least about 80 wt % of the core particle, and acoating comprising one or more surface-altering agents, wherein the oneor more surface-altering agents comprise at least one of a poloxamer, apoly(vinyl alcohol), or a polysorbate. The one or more surface-alteringagents is present on the outer surface of the core particle at a densityof at least 0.01 molecules/nm. The one or more surface-altering agentsis present in the pharmaceutical composition in an amount of betweenabout 0.001% to about 5% by weight. The plurality of coated particleshave an average smallest cross-sectional dimension of less than about 1micron. The pharmaceutical composition also includes one or moreophthalmically acceptable carriers, additives, and/or diluents.

It will be appreciated by one of ordinary skill in the art thatparticles suitable for use with the presently disclosed methods canexist in a variety of shapes, including, but not limited to, spheroids,rods, disks, pyramids, cubes, cylinders, nanohelixes, nanosprings,nanorings, rod-shaped particles, arrow-shaped particles, teardrop-shapedparticles, tetrapod-shaped particles, prism-shaped particles, and aplurality of other geometric and non-geometric shapes. In someembodiments, the presently disclosed particles have a spherical shape.

In one embodiment, the present invention provides a method of treatingor preventing paroxysmal nocturnal hemoglobinuria (PNH) by administeringto a subject in need thereof an effective amount of a compositioncomprising a compound of the current invention. In one embodiment, thepresent invention provides a method of treating or preventing paroxysmalnocturnal hemoglobinuria (PNH) by administering to a subject in needthereof an effective amount of a composition comprising a compound ofthe current invention in combination or alternation with additionalinhibitors of the complement system or another active compound with adifferent biological mechanism of action. In another embodiment, thepresent invention provides a method of treating or preventing paroxysmalnocturnal hemoglobinuria (PNH) by administering to a subject in needthereof an effective amount of a composition comprising a compound ofthe current invention in combination or alternation with eculizumab.

In one embodiment, the present invention provides a method of treatingor preventing rheumatoid arthritis by administering to a subject in needthereof an effective amount of a composition comprising a compound ofthe current invention. In one embodiment, the present invention providesa method of treating or preventing rheumatoid arthritis by administeringto a subject in need thereof an effective amount of a compositioncomprising a compound of the current invention in combination oralternation with an additional inhibitor of the complement system. Inanother embodiment, the present invention provides a method of treatingor preventing rheumatoid arthritis by administering to a subject in needthereof an effective amount of a composition comprising a compound ofthe current invention in combination or alternation with methotrexate.

In certain embodiments, a compound of Formula I is administered incombination or alternation with at least one anti-rhuematoid arthritisdrug selected from: salicylates including aspirin (Anacin, Ascriptin,Bayer Aspirin, Ecotrin) and salsalate (Mono-Gesic, Salgesic);nonsteroidal anti-inflammatory drugs (NSAIDs); nonselective inhibitorsof the cyclo-oxygenase (COX-1 and COX-2) enzymes, including diclofenac(Cataflam, Voltaren), ibuprofen (Advil, Motrin), ketoprofen (Orudis),naproxen (Aleve, Naprosyn), piroxicam (Feldene), etodolac (Lodine),indomethacin, oxaprozin (Daypro), nabumetone (Relafen), and meloxicam(Mobic); selective cyclo-oxygenase-2 (COX-2) inhibitors includingCelecoxib (Celebrex); disease-modifying antirheumatic drugs (DMARDs),including azathioprine (Imuran), cyclosporine (Sandimmune, Neoral®),gold salts (Ridaura, Solganal, Aurolate, Myochrysine),hydroxychloroquine (Plaquenil), leflunomide (Arava®), methotrexate(Rheumatrex), penicillamine (Cuprimine), and sulfasalazine (Azulfidine);biologic drugs including abatacept (Orencia), etanercept (Enbrel®),infliximab (Remicade®), adalimumab (Humira®), and anakinra (Kineret);corticosteroids including betamethasone (Celestone Soluspan), cortisone(Cortone), dexamethasone (Decadron), methylprednisolone (SoluMedrol,DepoMedrol), prednisolone (Delta-Cortef), prednisone (Deltasone,Orasone), and triamcinolone (Aristocort); gold salts, includingAuranofin (Ridaura); Aurothioglucose (Solganal); Aurolate; Myochrysine;or any combination thereof.

In one embodiment, the present invention provides a method of treatingor preventing multiple sclerosis by administering to a subject in needthereof an effective amount of a composition comprising a compound ofthe current invention. In one embodiment, the present invention providesa method of treating or preventing multiple sclerosis by administeringto a subject in need thereof an effective amount of a compositioncomprising a compound of the current invention in combination oralternation with additional inhibitors of the complement system. Inanother embodiment, the present invention provides a method of treatingor preventing multiple sclerosis by administering to a subject in needthereof an effective amount of a composition comprising a compound ofthe current invention in combination or alternation with acorticosteroid. Examples of corticosteroids include, but are not limitedto, prednisone, dexamethasone, solumedrol, and methylprednisolone.

In one embodiment, a compound of Formula I is combined with at least oneanti-multiple sclerosis drug selected from: Aubagio (teriflunomide),Avonex (interferon beta-1a), Betaseron (interferon beta-1b), Copaxone(glatiramer acetate), Extavia (interferon beta-1b), Gilenya(fingolimod), Lemtrada (alemtuzumab), Novantrone (mitoxantrone),Plegridy (peginterferon beta-1a), Rebif (interferon beta-1a), Tecfidera(dimethyl fumarate), Tysabri (natalizumab), Solu-Medrol(methylprednisolone), High-dose oral Deltasone (prednisone), H.P. ActharGel (ACTH), and combinations thereof.

In one aspect, a compound or salt of Formula I may be provided incombination or alternation with an immunosuppressive agent or ananti-inflammatory agent.

In one embodiment of the present invention, a compound described hereincan be administered in combination or alternation with at least oneimmunosuppressive agent. The immunosuppressive agent as nonlimitingexamples, may be a calcineurin inhibitor, e.g. a cyclosporin or anascomycin, e.g. Cyclosporin A (NEORAL®), FK506 (tacrolimus),pimecrolimus, a mTOR inhibitor, e.g. rapamycin or a derivative thereof,e.g. Sirolimus (RAPAMUNE®), Everolimus (Certican®), temsirolimus,zotarolimus, biolimus-7, biolimus-9, a rapalog, e.g. ridaforolimus,azathioprine, campath 1H, a S1P receptor modulator, e.g. fingolimod oran analogue thereof, an anti IL-8 antibody, mycophenolic acid or a saltthereof, e.g. sodium salt, or a prodrug thereof, e.g. MycophenolateMofetil (CELLCEPT®), OKT3 (ORTHOCLONE OKT3®), Prednisone, ATGAM®,THYMOGLOBULIN®, Brequinar Sodium, OKT4, T10B9.A−3A, 33B3.1,15-deoxyspergualin, tresperimus, Leflunomide ARAVA®, CTLAI-Ig,anti-CD25, anti-IL2R, Basiliximab (SIMULECT®), Daclizumab (ZENAPAX®),mizorbine, methotrexate, dexamethasone, ISAtx-247, SDZ ASM 981(pimecrolimus, Elidel®), CTLA41g (Abatacept), belatacept, LFA31g,etanercept (sold as Enbrel® by Immunex), adalimumab (Humira®),infliximab (Remicade®), an anti-LFA-1 antibody, natalizumab (Antegren®),Enlimomab, gavilimomab, antithymocyte immunoglobulin, siplizumab,Alefacept efalizumab, pentasa, mesalazine, asacol, codeine phosphate,benorylate, fenbufen, naprosyn, diclofenac, etodolac and indomethacin,aspirin and ibuprofen.

Examples of anti-inflammatory agents include methotrexate,dexamethasone, dexamethasone alcohol, dexamethasone sodium phosphate,fluromethalone acetate, fluromethalone alcohol, lotoprendol etabonate,medrysone, prednisolone acetate, prednisolone sodium phosphate,difluprednate, rimexolone, hydrocortisone, hydrocortisone acetate,lodoxamide tromethamine, aspirin, ibuprofen, suprofen, piroxicam,meloxicam, flubiprofen, naproxan, ketoprofen, tenoxicam, diclofenacsodium, ketotifen fumarate, diclofenac sodium, nepafenac, bromfenac,flurbiprofen sodium, suprofen, celecoxib, naproxen, rofecoxib,glucocorticoids, diclofenac, and any combination thereof. In oneembodiment, a compound of Formula I is combined with one or morenon-steroidal anti-inflammatory drugs (NSAIDs) selected from naproxensodium (Anaprox), celecoxib (Celebrex), sulindac (Clinoril), oxaprozin(Daypro), salsalate (Disalcid), diflunisal (Dolobid), piroxicam(Feldene), indomethacin (Indocin), etodolac (Lodine), meloxicam (Mobic),naproxen (Naprosyn), nabumetone (Relafen), ketorolac tromethamine(Toradol), naproxen/esomeprazole (Vimovo), and diclofenac (Voltaren),and combinations thereof.

VII. Process of Preparation of Compounds of Formula I Abbreviations

-   AcC1 acetyl chloride-   ACN acetonitrile-   dba dibenzylideneacetone-   DCM dichloromethane-   DIEA N,N-diisopropylethylamine-   DMA N,N-dimethylacetamide-   DMF N,N-dimethylformamide-   DMSO dimethyl sulfoxide-   dppf 1,1′-bis(diphenylphosphino)ferrocene-   EtOAc ethyl acetate-   FA formic acid-   HATU    1-[bis(dimethylamino)methylene]-1H−1,2,3-triazolo[4,5-b]pyridinium    3-oxid hexafluorophosphate-   IPA isopropyl alcohol-   MeOH methanol-   rt room temperature-   TBAF tetra-n-butylammonium fluoride-   TBDMS tert-butyldimethylsilyl-   TBDMSC1 tert-butyldimethylsilyl chloride-   TEA triethylamine-   TFA trifluoroacetic acid-   THF tetrahydrofuran-   TMSBr bromotrimethylsilane-   Xantphos 4,5-bis(diphenylphosphino)-9,9-dimethylxanthene

General Methods

All nonaqueous reactions were performed under an atmosphere of dry argonor nitrogen gas using anhydrous solvents. The progress of reactions andthe purity of target compounds were determined using one of the twoliquid chromatography (LC) methods listed below. The structure ofstarting materials, intermediates, and final products was confirmed bystandard analytical techniques, including NMR spectroscopy and massspectrometry.

LC Method A

Instrument: Waters Acquity Ultra Performance LC

Column: ACQUITY UPLC BEH C18 2.1×50 mm, 1.7 μm

Column Temperature: 40° C.

Mobile Phase: Solvent A: H₂O+0.05% FA; Solvent B: CH₃CN+0.05% FA

Flow Rate: 0.8 mL/min

Gradient: 0.24 min @ 15% B, 3.26 min gradient (15-85% B), then 0.5 min @85% B.

Detection: UV (PDA), ELS, and MS (SQ in EI mode)

LC Method B

Instrument: Shimadzu LC-2010A HT

Column: Athena, C18-WP, 50×4.6 mm, 5 μm

Column Temperature: 40° C.

Mobile Phase: Solvent A: H₂O/CH₃OH/FA=90/10/0.1; Solvent B:H₂O/CH₃OH/FA=10/90/0.1

Flow Rate: 3 mL/min

Gradient: 0.4 min @ 30% B, 3.4 min gradient (30-100% B), then 0.8 min @100% B

Detection: UV ( 220/254 nm)

Example 1 General Route of Synthesis

A compound of the present invention can be prepared, for example, from acentral core. In one embodiment, for example, the central core Structure1 is an N-protected aminoacid where X¹ is nitrogen and PG=protectinggroup. In one embodiment, the central core is coupled to an amine togenerate an amide of Structure 2 (wherein L-α includes a C(O)N moiety).Structure 2 can then be deprotected to generate Structure 3. Structure 3is coupled to Structure 4 (A-COOH) to generate a second amide bond,forming a compound within Formula I. The chemistry is illustrated inRoute 1.

Route 1

In an alternative embodiment, central core Structure 5 is reacted with aheterocyclic or heteroaryl compound to generate a compound of Structure6. In one embodiment, Structure 6 is deprotected to generate acarboxylic acid, Structure 7. In one embodiment, Structure 7 is coupledto an amine to generate a compound of Formula I. This chemistry isillustrated in Route 2.

Route 2

In an alternative embodiment, Structure 8 is deprotected to generate anamine which is Structure 9. Structure 9 is then coupled to generate anamide which is Structure 6. Structure 6 is then deprotected to generatea carboxylic acid which is Structure 7. Structure 7 is then coupled toform the amide which falls within Formula I. The chemistry isillustrated in Route 3.

Route 3

In an alternate embodiment, a heteroaryl or aryl moiety, 4-1, is coupledto a central core to generate 4-2. The protected acid, 4-2 is deblockedto form the carboxylic acid, 4-3. The carboxylic acid is then coupled toform an amide (L-α) which is 4-4. The heteroaryl or aryl moiety, A′, canthen be further derivitized to add substituents at the X¹¹, X¹², X¹³ andX¹⁴ positions to generate compounds of Formula I. This chemistry isillustrated in Route 4.

Route 4

In an alternate embodiment, Structure 5-1 is coupled to an acid,Structure 5-2, to generate Structure 5-3. The carboxylic acid, Structure5-3, is deblocked to generate a carboxylic acid which is Structure 5-4.Carboxylic acid Structure 5-4 is coupled to an amine to form the productamide (L-α) which is a compound within Formula I. This chemistry isillustrated in Route 5.

Route 5

In an alternate embodiment, a heteroaryl compound of Structure 6-1 isprotected to generate a compound of Structure 6-2, wherein PG is aprotecting group. Structure 6-2 is then activated with a leaving group,LG, to generate Structure 6-3. Structure 6-3 is treated with anactivated ester, Structure 6-4, to generate Structure 6-5. Structure 6-5is deprotected and treated with 3 organometallic catalyst to generateStructure 6-6. In some embodiments, the organometallic catalysts arePd(dppf)Cl₂, Pd₂(dba)₃ and Zn(CN)₂ to create a heteroaryl compoundhaving a R⁶ group. In some embodiments, the R⁶ group is cyano. Structure6-6 is treated with an oxime to generate an amide at the R⁶ position,Structure 6-7. Structure 6-7 is treated with two organometalliccatalysts, a base, an organic solvent and a halide to generate acompound of Structure 6-8. In some embodiments, the halide is an arylhalide. In some embodiments, the halide is a heteroaryl halide. In someembodiments, the organometallic catalysts aretris(dibenzylideneacetone)dipalladium(0) and4,5-bis(diphenylphosphino)-9,9-dimethylxanthene. In some embodiments,the base is cesium carbonate. In some embodiments, the organic solventis DMF. Structure 6-8 is treated with an organic acid such as, but notlimited to, trifluoroacetic acid. The product, a carboxylic acid iscoupled to Structure 3 from Route 1 to generate a compound withinFormula I. This chemistry is illustrated in Route 6.

Route 6

In an alternate embodiment, a heteroaryl compound of Structure 7-1 isprotected to generate a compound of Structure 7-2, wherein PG is aprotecting group. Structure 7-2 is then activated with a leaving groupto generate Structure 7-3. Structure 7-3 is treated with an activatedester of Structure 7-4 to generate Structure 7-5. Structure 7-5 isdeprotected and treated with 3 organometallic catalyst to generateStructure 7-6. In some embodiments, the organometallic catalysts arePd(dppf)Cl₂, Pd₂(dba)₃ and Zn(CN)₂ to create a heteroaryl compoundhaving a R⁶ group. In some embodiments, the R⁶ group is cyano. Structure7-6 is treated with an oxime to generate an amide at the R⁶ position,Structure 7-6′. Structure 7-6′ is treated with two organometalliccatalysts, a base, an organic solvent and a halide to generate acompound of Structure 7-7. In some embodiments, the halide is an arylhalide. In some embodiments, the halide is a heteroaryl halide. In someembodiments, the organometallic catalysts aretris(dibenzylideneacetone)dipalladium(0) and4,5-bis(diphenylphosphino)-9,9-dimethylxanthene. In some embodiments,the base is cesium carbonate. In some embodiments, the organic solventis DMF. Structure 7-7 is treated with an organic acid such as, but notlimited to, trifluoroacetic acid. The product, a carboxylic acid iscoupled to Structure 3 from Scheme 1 to generate a compound withinFormula I. This chemistry is illustrated in Scheme 7.

In another embodiment, a heteroaryl compound of Structure 8-1 isacylated to form Structure 8-2. Structure 8-2 is treated with anactivated ester, Structure 8-3, to generate Structure 8-4. In someembodiments, the leaving group, LG, is a halide. The protecting group isremoved to generate the alcohol which is Structure 8-5. In someembodiments the protecting group is benzyl. Structure 8-5 is treatedwith a base to generate acid 8-6. In some embodiments, the base islithium hydroxide. Structure 8-6 is coupled to Structure 3 of Route 1 togenerate Structure 8-7. Structure 8-7 can be treated with variousactivated moieties to generate compounds within Formula I. For example,Structure 8-7 can be treated with a base, an organic solvent and LG-R³²wherein LG is a leaving group to generate compounds within Formula I.This chemistry is illustrated in Route 8. In some embodiments, theleaving group is a tosylate. In some embodiments, the leaving group is ahalide. In some embodiments, the base is triethylamine. In oneembodiment, structure 8-7 is treated with -LG(CH₂)₁₋₄P(O)R^(23b)R^(23b).In some embodiments, LG is a leaving group. In some embodiments, LG is atosylate. In some embodiments, R^(23b) is ethoxy. In some embodiments,the diethyl phosphonate product is hydrolyzed to a phosphonic acid. Insome embodiments, the phosphonic acid is coupled to a chlorocarbonate togenerate a compound of Formula I.

Route 8

In another embodiment, a heteroaryl compound of Structure 9-1 isacylated to form Structure 9-2. In an alternate embodiment, Structure9-1 is treated with an inorganic cyanide to introduce a cyano group atthe R⁶ position. The cyano compound can be treated with an oxime togenerate an amide at the R⁶ position. Structure 9-2 is treated with anactivated ester, Structure 9-3, to generate Structure 9-4. In someembodiments, the leaving group, LG, is a halide. The protecting group isremoved to generate the alcohol which is Structure 9-5. In someembodiments the protecting group is benzyl. Structure 9-5 is treatedwith a base to generate acid 9-6. In some embodiments, the base islithium hydroxide. Structure 9-6 is coupled to Structure 3 of Route 1 togenerate Structure 9-7. Structure 9-7 can be treated with variousmoieties to generate compounds within Formula I. For example, Structure9-7 can be treated with a base, an organic solvent and LG-R³² wherein LGis a leaving group to generate compounds within Formula I. Thischemistry is illustrated in Route 9. In some embodiments, the leavinggroup is a tosylate. In some embodiments, the leaving group is a halide.In some embodiments, the base is triethylamine. In some embodiments, thebase is triethylamine. In one embodiment, structure 9-7 is treated with-LG(CH₂)₁₋₄P(O)R^(23b)R^(23b). In some embodiments, LG is a leavinggroup. In some embodiments, LG is a tosylate. In some embodiments,R^(23b) is ethoxy. In some embodiments, the diethyl phosphonate productis hydrolyzed to a phosphonic acid. In some embodiments, the phosphonicacid is coupled to a chloro carbonate to generate a compound of FormulaI.

Route 9

In another embodiment, a heteroaryl compound of Structure 10-1 isacylated to form Structure 10-2. In an alternate embodiment, Structure10-1 is treated with an inorganic cyanide to introduce a cyano group atthe R⁶ position. The cyano compound can be treated with an oxime togenerate an amide at the R⁶ position. Structure 10-2 is treated with anactivated ester, Structure 10-3, to generate Structure 10-4. In someembodiments, the leaving group, LG, is a halide. The protecting group isremoved to generate the alcohol which is Structure 10-5. In someembodiments the protecting group is benzyl. Structure 10-5 is treatedwith a base to generate acid 10-6. In some embodiments, the base islithium hydroxide. Structure 10-6 is coupled to Structure 3 of Route 1to generate Structure 10-7. Structure 10-7 can be treated with variousmoieties to generate compounds within Formula I. For example, Structure10-7 can be treated with a base, an organic solvent and LG-R³² whereinLG is a leaving group to generate compounds within Formula I. In someembodiments, the leaving group is a tosylate. In some embodiments, theleaving group is a halide. In some embodiments, the base istriethylamine. In some embodiments, the base is 23b. I_(n)triethylamine. In one embodiment, structure 10-7 is treated with-LG(CH₂)₁₋₄P(O)R^(23b)R^(23b). In some embodiments, LG is a leavinggroup. In some embodiments, LG is a tosylate. In some embodiments,R^(23b) is ethoxy. In some embodiments, the diethyl phosphonate productis hydrolyzed to a phosphonic acid. In some embodiments, the phosphonicacid is coupled to a chloro carbonate to generate a compound of FormulaI. This chemistry is illustrated in Route 10.

Route 10

In another embodiment, a heteroaryl compound of Structure 11-1 isacylated to generate Structure 11-2. In an alternate embodiment,Structure 11-1 is treated with an inorganic cyanide to introduce a cyanogroup at the R⁶ position. The cyano compound can be treated with anoxime to generate an amide at the R⁶ position. Structure 11-2 is treatedwith an activated ester, Structure 11-3, to generate Structure 11-4. Insome embodiments, the leaving group, LG, is a halide. The protectinggroup is removed to generate the alcohol which is Structure 11-5. Insome embodiments the protecting group is benzyl. Structure 11-5 istreated with a base to generate acid 11-6. In some embodiments, the baseis lithium hydroxide. Structure 11-6 is coupled to Structure 3 of Route1 to generate Structure 11-7. Structure 11-7 can be treated with variousmoieties to generate compounds within Formula I. For example, Structure11-7 can be treated with a base, an organic solvent and LG-R³² whereinLG is a leaving group to generate compounds within Formula I. In someembodiments, the leaving group is a tosylate. In some embodiments, theleaving group is a halide. In some embodiments, the base istriethylamine. In one embodiment, structure 11-7 is treated with-LG(CH₂)₁₋₄P(O)R^(23b)R^(23b). In some embodiments, LG is a leavinggroup. In some embodiments, LG is a tosylate. In some embodiments,R^(23b) is ethoxy. In some embodiments, the diethyl phosphonate productis hydrolyzed to a phosphonic acid. In some embodiments, the phosphonicacid is coupled to a chloro carbonate to generate a compound withinFormula I. This chemistry is illustrated in Route 11.

Route 11

In an alternate embodiment, Structure 12-1 is coupled to an amine togenerate an amide (L-α), which is Structure 12-2. Structure 12-2, iscoupled to an amine to generate compounds within Formula I. Thischemistry is illustrated in Route 12.

Route 12 Example 2 Examples of Central Synthons

Z^(A) is halogen.

In one embodiment, deuterated L-proline synthons are disclosed.Deuterated synthons include, but are not limited to, for example, thefollowing compounds:

Structure A can be treated with deuterium oxide to generate Structure B.See, Barraclough, P. et al. Tetrahedron Lett. 2005, 46, 4653-4655;Barraclough, P. et al. Org. Biomol. Chem. 2006, 4,1483-1491 and WO2014/037480 (p. 103). Structure B can be reduced to generate StructureC. See, Barraclough, P. et al. Tetrahedron Lett. 2005, 46, 4653-4655;Barraclough, P. et al. Org. Biomol. Chem. 2006, 4,1483-1491. Structure Ccan be treated with Mitsunobu reaction conditions to generate StructureD. Structure B can be treated with DAST to generate Structure E. See, WO2014/037480. Structure A can be treated with sodium borodeuteride togenerate Structure F. See, Dormoy, J.-R.; Castro, B. Synthesis 1986,81-82. Compound F can be used to generate Structure K. See, Dormoy,J.-R.; Castro, B. Synthesis 1986, 81-82. Structure B can be treated witha deuterated reducing agent, for example sodium borodeuteride togenerate Structure G. Structure G can be treated with DAST to generateStructure H. Structure F can be used to generate Structure K. See,Dormoy, J.-R.; Castro, B. Synthesis 1986, 81-82. Structure G can be usedto generate Structure I. Structure J can be prepared according to Hruby,V. J. et al. J. Am. Chem. Soc. 1979, 101, 202-212. Structures A-J can beused to prepare compounds of Formula I.

Example 3 Preparation of Central-L-α Synthons

Routes 1a, 1b and 1c.

In Route 1a, 5-azaspiro[2.4]heptane-4,5-dicarboxylic acid,5-(1,1-dimethylethyl) ester, (4S)—, CAS 209269-08-9, can be prepared asdescribed in Tandon, M. et al. Bioorg. Med. Chem. Lett. 1998, 8,1139-1144. In Step 2, the protected azaspiro[2.4]heptane is coupled toan amine in the presence of an organic solvent, a base and a couplingreagent to generate an amide bond; the L-α moiety. In one embodiment,the amine is (3-chloro-2-fluorophenyl) methanamine. In one embodiment,the organic solvent is DMF. In one embodiment, the base isdiisopropylethylamine. In one embodiment, the coupling reagent is HATU.In Step 3, the protecting group is removed. In one embodiment, thestarting material is reacted with an acid in the presence of an organicsolvent. In one embodiment, the acid is 4N hydrochloric acid. In oneembodiment, the organic solvent is dioxane.

In Route 1b, (4S) 4-oxazolidinecarboxylic acid, hydrochloride is treatedwith an amine protecting reagent. In one embodiment, the amineprotecting reagent is di-tert-butyl dicarbonate. In another embodiment,3,4-oxazolidinedicarboxylic acid, 3-(1,1-dimethylethyl) ester, (4S)—, iscommercially available from JPM2 Pharmaceuticals. In one embodiment thereaction is carried out in an organic solvent in the presence of a base.In one embodiment, the organic solvent is acetonitrile. In oneembodiment, the base is 4-dimentylaminopyridine (DMAP). In Step 2, theprotected 4-oxazolidinecarboxylic acid is coupled to an amine in thepresence of an organic solvent, a base and a coupling reagent togenerate an amide bond; the L-α moiety. In one embodiment, the amine is(3-chloro-2-fluorophenyl) methanamine. In one embodiment, the organicsolvent is DMF. In one embodiment, the base is diisopropylethylamine. Inone embodiment, the coupling reagent is HATU. In Step 3, the protectinggroup is removed. In one embodiment, the starting material is reactedwith an acid in the presence of an organic solvent. In one embodiment,the acid is 4N hydrochloric acid. In one embodiment, the organic solventis dioxane.

In Route 1c, (S)-5-(tert-Butoxycarbonyl)-5-azaspiro[2.4]heptane-6-αaboxylic acid, CAS 1129634-44-1, is commercially available from ArkPharm. In Step 2, the carboxylic acid is coupled to an amine in thepresence of an organic solvent, a base and a coupling reagent togenerate an amide bond; the L-α moiety. In one embodiment, the amine is(3-chloro-2-fluorophenyl) methanamine. In one embodiment, the organicsolvent is DMF. In one embodiment, the base is diisopropylethylamine. Inone embodiment, the coupling reagent is HATU. In Step 3, the protectinggroup is removed. In one embodiment, the starting material is reactedwith an acid in the presence of an organic solvent. In one embodiment,the acid is 4N hydrochloric acid. In one embodiment, the organic solventis dioxane.

Routes 2a, 2b, 2c, and 2d.

In Route 2a, commercially available Boc-L-proline is coupled to an aminein the presence of an organic solvent, a base and a coupling reagent togenerate an amide bond; the L-α moiety. In one embodiment, the amine is(3-chloro-2-fluorophenyl) methanamine. In one embodiment, the organicsolvent is DMF. In one embodiment, the base is diisopropylethylamine. Inone embodiment, the coupling reagent is HATU. In Step 2, the Bocprotecting group is removed. In one embodiment, the starting material isreacted with an acid in the presence of an organic solvent. In oneembodiment, the acid is 4N hydrochloric acid. In one embodiment, theorganic solvent is dioxane.

In Route 2b, commercially available(1R,3S,5R)-2-[(tert-butoxy)carbonyl]-2-azabicyclo[3.1.0]hexane-3-carboxylicacid, from Enamine, is coupled to an amine in the presence of an organicsolvent, a base and a coupling reagent to generate an amide bond; theL-α moiety. In one embodiment, the amine is (3-chloro-2-fluorophenyl)methanamine. In one embodiment, the organic solvent is DMF. In oneembodiment, the base is diisopropylethylamine. In one embodiment, thecoupling reagent is HATU. In Step 2, the Boc protecting group isremoved. In one embodiment, the starting material is reacted with anacid in the presence of an organic solvent. In one embodiment, the acidis 4N hydrochloric acid. In one embodiment, the organic solvent isdioxane.

In Route 2c, commercially available(2S,4R)-1-(tert-butoxycarbonyl)-4-fluoropyrrolidine-2-carboxylic acid,from Manchester Organics, is coupled to an amine in the presence of anorganic solvent, a base and a coupling reagent to generate an amidebond; the L-α moiety. In one embodiment, the amine is(3-chloro-2-fluorophenyl) methanamine. In one embodiment, the organicsolvent is DMF. In one embodiment, the base is diisopropylethylamine. Inone embodiment, the coupling reagent is HATU. In Step 2, the Bocprotecting group is removed. In one embodiment, the starting material isreacted with an acid in the presence of an organic solvent. In oneembodiment, the acid is 4N hydrochloric acid. In one embodiment, theorganic solvent is dioxane.

In Route 2d, commercially available(S)-1-(tert-butoxycarbonyl)indoline-2-carboxylic acid, from Chem-Impex,is coupled to an amine in the presence of an organic solvent, a base anda coupling reagent to generate an amide bond; the L-α moiety. In oneembodiment, the amine is (3-chloro-2-fluorophenyl) methanamine. In oneembodiment, the organic solvent is DMF. In one embodiment, the base isdiisopropylethylamine. In one embodiment, the coupling reagent is HATU.In Step 2, the Boc protecting group is removed. In one embodiment, thestarting material is reacted with an acid in the presence of an organicsolvent. In one embodiment, the acid is 4N hydrochloric acid. In oneembodiment, the organic solvent is dioxane. This chemistry isillustrated in Scheme 2.

Additional starting materials that can readily be converted toCentral-L-α-Synthons include, but are not limited to:(S)-1-(tert-butoxycarbonyl)-2,3-dihydro-1H-pyrrole-2-carboxylic acid,CAS 90104-21-5, available from Ark Pharm;cyclopent-1-ene-1,2-dicarboxylic acid, CAS 3128-15-2, purchased from ArkPharm; imidazole, 1H-imidazole-1,2-dicarboxylic acid,1-(1,1-dimethylethyl) 2-ethyl ester, CAS 553650-00-3, commerciallyavailable from FCH Group; Boc-L-octahydroindole-2-carboxylic acid can bepurchased from Chem Impex. The compound,

can be prepared according to the procedures disclosed in WO 2004/111041;(S)—Boc-5-oxopyrrolidine-2-carboxylic acid is available from the AldrichChemical Co.;(1S,2S,5R)-3-(tert-butoxycarbonyl)-3-azabicyclo[3.3.0]hexane-2-carboxylicacid is available from Ark Pharm; (S)-3-Boc-thiazolidine-2-carboxylicacid is available from Alfa Aesar;(2S,4R)-1-(tert-butoxycarbonyl)-4-chloropyrrolidine-2-carboxylic acid isavailable from Arch Bioscience; (1 S,3aR,6aS)-2-(tert-butoxycarbonyl)octahydrocyclopenta[c]pyrrole-1-carboxylicacid is available from Ark Pharm; 1,2-pyrrolidinedicarboxylic acid,3-[[(phenylmethoxy)carbonyl]amino]—, 1-(1,1-dimethylethyl) ester,(2S,3R) can be prepared as disclosed in WO 2004/007501. The Cbz groupcan be removed and the amino group can be alkylated to generate centralcore compounds of the present invention.

The compound

can be prepared as disclosed by Braun, J. V.; Heymons, Albrecht Berichteder Deutschen Chemischen Gesellschaft [Abteilung]B: Abhandlungen (1930)63B, 502-7.

The compounds (2S,3S,4S)-4-fluoro-3-methoxy-pyrrolidine-1,2-dicarboxylicacid 1-tert-butyl ester and(2R,3R,4R)-3-fluoro-4-methoxy-pyrrolidine-1,2-dicarboxylic acid1-tert-butyl ester can be prepared as a mixture according to WO2012/093101 to Novartis and the regioisomers can be ultimately separatedonce coupled to generate the central core-L-α synthons. The compound(S)—Boc-5-oxopyrrolidine-2-carboxylic acid is available from the AldrichChemical Co.

Example 4 Synthesis of 4A. (2S,4R)-tert-butyl2-((3-chloro-2-fluoro-benzyl)carbamoyl)-4-fluoropyrrolidine-1-carboxylate

(2S,4R)-1-(tert-butoxycarbonyl)-4-fluoropyrrolidine-2-carboxylic acid(2.33 μm, 10 mmol) was dissolved in DMF (50 ml) and ^(i)Pr₂NEt (8.6 ml,5 eq.) was added, followed by the addition of (3-chloro-2-fluorophenyl)methanamine (3.18 μm 20 mmol) at 5° C. Then HATU (8 μm, 2.1 eq) wasadded slowly at same temperature. The reaction mixture was then stirredfor 18 h at RT. After completion of the reaction monitored by HPLC, Thereaction mixture was diluted with 1M citric acid solution (200 ml+NaClsolid 20 μm) and extracted with DCM (150 mL×2), the organic layer wasthen washed with an aqueous solution of NaHCO₃ (100 ml) and washed withwater (100 ml), brine (100 ml) and dried over Na₂SO₄ and concentratedunder reduced pressure. The remaining residue was purified by columnchromatography (eluted with DCM/EtOAc) to give (2S,4R)-tert-butyl2-((3-chloro-2-fluorobenzyl)carbamoyl)-4-fluoropyrrolidine-1-carboxylate.

4B.(2S,4R)—N-(3-chloro-2-fluorobenzyl)-4-fluoropyrrolidine-2-carboxamidehydrochloride(A)

(2S,4R)-tert-butyl2-((3-chloro-2-fluorobenzyl)carbamoyl)-4-fluoropyrrolidine-1-carboxylate(500 mg,) was taken in 4N HCl dioxane (30 ml) and resulting reactionmixture was stirred at rt for 3 h. After completion of the reactionmonitored by HPLC solvent was removed under reduced pressure. Theresidue, A, was used for next reaction.

Example 5 Syntheses of Non-Limiting Examples of Compounds of Formula I

5-((tert-Butyldimethylsilyl)oxy)-1H-indazole (2)

To a solution of 1H-indazol-5-ol (50 g, 1 equiv) in DMF (500 mL) wereadded imidazole (63.4 g, 2.5 equiv) and TBDMS chloride (67.4 g, 1.2 eq.)at 0° C. The reaction mixture was stirred at rt for 3 h, then pouredover water until a precipitated solid appeared. The solid was collectedby filtration, washed with water, and dried.

5-((tert-Butyldimethylsilyl)oxy)-3-iodo-1H-indazole (3)

To a solution of 5-((tert-butyldimethylsilyl)oxy)-1H-indazole (45 g, 1equiv) in THF (450 mL) were added iodine (69 g, 1.5 equiv) and potassiumtert-butoxide (50.8 g, 2.5 equiv) at 0° C. The reaction mixture wasstirred at rt for 12 h. The mixture was diluted with 10% sodiumthiosulfate and water, and then extracted with EtOAc. The combinedorganic extracts were washed with brine, and then dried. The residualcrude product was purified by column chromatography.

tert-Butyl2-(5-((tert-butyldimethylsilyl)oxy)-3-iodo-1H-indazol-1-yl)acetate (4)

To 5-((tert-butyldimethylsilyl)oxy)-3-iodo-1H-indazole (10 g, 1 equiv)and potassium carbonate (9.2 g, 2.5 equiv) in DMF (100 mL) was addedtert-butyl bromoacetate (4.3 mL, 1.1 equiv) dropwise at rt. Theresulting mixture was stirred for 2 h, poured into water, and extractedwith EtOAc. The combined organic extracts were concentrated underreduced pressure. The material thus obtained was used without furtherpurification in the next step.

tert-Butyl 2-(5-hydroxy-3-iodo-1H-indazol-1-yl)acetate (5)

To a solution of tert-butyl2-(5-((tert-butyldimethylsilyl)oxy)-3-iodo-1H-indazol-1-yl)acetate (144g, 1 equiv) in THF (1440 mL) was added TBAF (1M solution in THF, 324 mL,1.1 equiv) at 0° C. and the resulting mixture was stirred at rt for 2 h.The reaction mixture was poured into ice water and extracted with EtOAc;the combined organic extracts were concentrated under reduced pressure.The residual crude product was purified by column chromatography.

tert-Butyl 2-(3-cyano-5-hydroxy-1H-indazol-1-yl)acetate (6)

A mixture of tert-butyl 2-(5-hydroxy-3-iodo-1H-indazol-1-yl)acetate (86g, 1 equiv), Zn(CN)₂ (29.7 g, 1.1 equiv), Pd(dppf)Cl₂ (16.8 g, 0.1equiv), Pd₂(dba)₃ (21 g, 0.1 equiv), water (86 mL), and DMF (860 mL) wasstirred at 80° C. for 3 h under nitrogen. The reaction mixture wasdiluted with EtOAc and then successively washed with water, sat. aq.NaHCO₃, and brine. The combined organic layer was concentrated underreduced pressure. The crude residue was purified by columnchromatography on silica gel (Hexane/EtOAc).

tert-Butyl 2-(3-carbamoyl-5-hydroxy-1H-indazol-1-yl)acetate (7)

A mixture of tert-butyl 2-(3-cyano-5-hydroxy-1H-indazol-1-yl) acetate(49 g, 1 equiv), acetaldoxime (21.2 g, 2 equiv), Pd (OAc)₂ (2 g, 0.05equiv) and PPh₃ (5 g, 0.1 equiv) in aqueous ethanol (1125 mL, H₂O/EtOH(245 mL/980 mL)) was heated to reflux for 3 h under a nitrogenatmosphere. The reaction mixture was filtered through Celite® and thesolvent was removed under vacuum. The crude residue was purified bycolumn chromatography on silica gel (Hexane/EtOAc).

tert-Butyl 2-(3-carbamoyl-5-(pyrimidin-5-yloxy)-1H-indazol-1-yl) acetate(8)

A mixture of 873 mg (1 equiv) of compound 7, 5-bromopyrimidine (569 mg,1.2 equiv), cesium carbonate (1.95 g, 2 equiv), and DMF (40 mL) waspurged with argon in a pressure vessel for 5 min, thentris(dibenzylideneacetone)dipalladium(0) (0.01 equiv) and4,5-bis(diphenylphosphino)-9,9-dimethylxanthene (0.01 equiv) were addedunder argon. The pressure vessel was sealed and heated at 100° C. for 24h. The reaction mixture was cooled to rt and the solvent was removedunder reduced pressure. The remaining residue was purified by flashcolumn chromatography (ISCO eluted with DCM/CH₃OH) to give 8.

2-(3-Carbamoyl-5-(pyrimidin-5-yloxy)-1H-indazol-1-yl)acetic acid (9)

tert-Butyl 2-(3-carbamoyl-5-(pyrimidin-5-yloxy)-1H-indazol-1-yl)acetate(100 mg) was stirred in a 1:1 mixture of CH₂Cl₂-TFA (10 mL) at rt for 4h. The volatiles were then removed under reduced pressure. The remainingmaterial was used directly in the next synthetic step.

1-(2-02S,4R)-2-02′-Chloro-2-fluoro-[1,1′-biphenyl]-3-yl)carbamoyl)-4-fluoropyrrolidin-1-yl)-2-oxoethyl)-5-(pyrimidin-5-yloxy)-1H-indazole-3-carboxamide(11)

2-(3-Carbamoyl-5-(pyrimidin-5-yloxy)-1H-indazol-1-yl)acetic acid 9 (60mg, 0.191 mmol) from the previous step was dissolved in DMF (10 mL) andiPr₂NEt (0.160 mL, 5 eq.) was added, which was followed by the additionof(2S,4R)—N-(2′-chloro-2-fluoro-[1,1′-biphenyl]-3-yl)-4-fluoropyrrolidine-2-carboxamidehydrochloride (71 mg, 1 equiv) at 5° C. HATU (153 mg, 2.1 eq) was thenadded slowly at the same temperature and the reaction mixture wasstirred for 5 h at rt. After completion of the reaction monitored byHPLC, the reaction mixture was added to water (50 mL+5 g NaCl) andextracted with DCM (2×25 mL). The organic layer was washed successivelywith an aqueous solution of NaHCO₃ (20 mL), water (20 mL), and brine (20mL), then dried over Na₂SO₄ and concentrated under reduced pressure. Theremaining residue was purified by flash column chromatography (ISCOeluted with DCM/CH₃OH) to give 11. ¹H NMR (400 MHz, DMSO-d₆, 300 K):(major rotamer) δ 2.12-2.28 (m, 1H), 2.54-2.62 (m, 1H), 3.61-3.62 (m,1H), 3.90-4.02 (m, 1H), 4.19-4.27 (m, 1H), 4.78 (t, J=8 Hz, 1H),5.48-5.76 (m, 3H), 7.07 (t, J=8 Hz, 1H), 7.22 (t, J=8 Hz, 1H), 7.34-7.59(m, 7H), 7.69-7.70 (m, 1H), 7.97 (t, J=8 Hz, 1H), 8.64 (s, 2H), 9.00 (s,1H), 9.99 (s 1H); ¹⁹F NMR (376 MHz, DMSO-d₆, 300 K): (major rotamer) δ−126.72, −175.85. LC (method A): t_(R)=2.72 min. LC/MS (EI) m/z: [M+H]+calcd for C₃₁H₂₄C₁F₂N₇O₄, 631. found, 632.

2′-Chloro-2-fluoro-[1,1′-biphenyl]-3-amine hydrochloride (14)

The mixture of 12 (30 g), 13 (60 g), K₂CO₃ (91 g) and Pd(dppf)₂Cl₂(19.25 g) in solvent (dioxane 400 mL, H₂O 100 mL) was purged with argonin a pressure vessel for 5 min and stirred for 15 h at 100° C. Thesolvent was removed under reduced pressure and the remaining residue waspurified by flash column chromatography. The purified material was thendissolved in MeOH and treated with HCl/MeOH. The solvent was removed andthe remaining solid was washed with IPA-heptane (1/1) to afford 14.

(2S,4R)-tert-Butyl2-02′-chloro-2-fluoro-[1,1′-biphenyl]-3-yl)carbamoyl)-4-fluoropyrrolidine-1-carboxylate(16)

To an ice-cold solution of 15 (530 mg) in 20 mL of CH₂Cl₂,1-chloro-N,N,2-trimethylpropenylamine (0.333 mL, 1.1 equiv.) was addeddropwise with stirring. The stirring was continued for 3 h at thistemperature, then solid 14 (640 mg, 1.1 equiv) was added, followed by1.12 mL of iPr₂NEt (3 equiv). The cooling bath was removed and thereaction mixture was stirred overnight at rt. After completion of thereaction monitored by HPLC, the reaction mixture was added to water (20mL) and extracted with DCM (2×25 mL). The organic layer was washedsuccessively with an aqueous solution of NaHCO₃ (20 mL), water (20 mL),and brine (20 mL), then dried over Na₂SO₄ and concentrated under reducedpressure. The remaining residue was purified by flash columnchromatography (ISCO eluted with Hexanes/EtOAC) to give 16.

(2S,4R)—N-(2′-Chloro-2-fluoro-[1,1′-biphenyl]-3-yl)-4-fluoropyrrolidine-2-carboxamidehydrochloride (10)

(2S,4R)-tert-Butyl2-((2′-chloro-2-fluoro-[1,1′-biphenyl]-3-yl)carbamoyl)-4-fluoropyrrolidine-1-carboxylate16 (700 mg) was taken in 4N HCl dioxane (25 mL) and the resultingreaction mixture was stirred at rt for 3 h. After completion of thereaction monitored by HPLC, the solvent was removed under reducedpressure. The remaining residue 10 was used directly in the nextsynthetic step (preparation of 11).

Example 6 Additional Syntheses of Non-Limiting Examples of Compounds ofFormula I

2′-Chloro-2-fluoro-[1,1′-biphenyl]-3-amine hydrochloride (Int-1)

A mixture of 3-bromo-2-fluoroaniline (30 g), (2-chlorophenyl)boronicacid (60 g), K₂CO₃ (91 g), and Pd(dppf)₂Cl₂ (19.25 g) in solvent(dioxane 400 mL, H₂O 100 mL) was purged with argon gas in a pressurevessel for 5 min and stirred for 15 h at 100° C. The solvent was thenremoved under reduced pressure and the remaining residue was purified byflash column chromatography. The purified material was dissolved in MeOHand treated with HCl/MeOH. The solvent was removed under reducedpressure and the remaining solid was washed with IPA-heptane (1:1) toafford 2′-chloro-2-fluoro-[1,1′-biphenyl]-3-amine hydrochloride.

(2S,4R)-tert-Butyl2-((2′-chloro-2-fluoro-[1,1′-biphenyl]-3-yl)carbamoyl)-4-fluoropyrrolidine-1-carboxylate

To an ice-cold solution of(2S,4R)-1-(tert-butoxycarbonyl)-4-fluoropyrrolidine-2-carboxylic acid(530 mg) in DCM (20 mL) was added 1-chloro-N,N,2-trimethylpropenylamine(0.333 mL, 1.1 equiv) dropwise with stirring. The stirring was continuedfor 3 h at this temperature and then solid2′-chloro-2-fluoro-[1,1′-biphenyl]-3-amine hydrochloride (640 mg, 1.1equiv) was added, followed by DIEA (1.12 mL, 3 equiv). The cooling bathwas removed and the reaction mixture was stirred overnight at rt. Aftercompletion of the reaction (as judged by HPLC analysis), the reactionmixture was added to water (20 mL) and extracted with DCM (2×25 mL). Theorganic layer was washed successively with an aqueous solution of NaHCO₃(20 mL), water (20 mL), and brine (20 mL), then dried over Na₂SO₄ andconcentrated under reduced pressure. The remaining residue was purifiedby column chromatography (eluted with hexanes/EtOAc) to give tert-butyl(2S,4R)-2-((2′-chloro-2-fluoro-[1,1′-biphenyl]-3-yl)carbamoyl)-4-fluoropyrrolidine-1-carboxylate.

(2S,4R)—N-(2′-Chloro-2-fluoro-[1,1′-biphenyl]-3-yl)-4-fluoropyrrolidine-2-carboxamidehydrochloride (Int-1)

(2S,4R)-tert-Butyl2-((2′-chloro-2-fluoro-[1,1′-biphenyl]-3-yl)carbamoyl)-4-fluoropyrrolidine-1-carboxylate(700 mg) was taken in 4 N HCl in dioxane (25 mL) and the resultingreaction mixture was stirred at rt for 3 h. The solvent was removedunder reduced pressure to give Int-1.

(2S,4R)-tert-Butyl2-((3-chloro-2-fluorobenzyl)carbamoyl)-4-fluoropyrrolidine-1-carboxylate

(2S,4R)-1-(tert-Butoxycarbonyl)-4-fluoropyrrolidine-2-carboxylic acid(2.33 g, 10 mmol) was dissolved in DMF (50 ml) and DIEA (8.6 mL, 5equiv) was added, followed by the addition of (3-chloro-2-fluorophenyl)methanamine (3.18 g, 20 mmol) at 5° C. HATU (8 g, 2.1 equiv) was thenadded slowly at this temperature. The reaction mixture was stirred for18 h at rt, diluted with 1 M citric acid solution (200 mL+20 g solidNaCl), and extracted with DCM (2×150 mL). The organic layer was thenwashed with an aqueous solution of NaHCO₃ (100 mL), water (100 mL), andbrine (100 mL), then dried over Na₂SO₄ and concentrated under reducedpressure. The remaining residue was purified by column chromatography(eluted with DCM/EtOAc) to give (2S,4R)-tert-butyl2-((3-chloro-2-fluorobenzyl)carbamoyl)-4-fluoropyrrolidine-1-carboxylate.

(2S,4R)—N-(3-Chloro-2-fluorobenzyl)-4-fluoropyrrolidine-2-carboxamidehydrochloride (Int-2)

(2S,4R)-tert-Butyl2-((3-chloro-2-fluorobenzyl)carbamoyl)-4-fluoropyrrolidine-1-carboxylate(500 mg) was taken in 4 N HCl in dioxane (30 mL) and the resultingreaction mixture was stirred at rt for 3 h. The solvent was removedunder reduced pressure to give Int-2.

1-(5-(Benzyloxy)-1H-indol-3-yl)ethanone

To a stirred solution of 5-(benzyloxy)-1H-indole (11.08 g, 1 equiv) inDCM (200 mL) was added diethylaluminium chloride (1 M solution inhexane; 74.6 mL, 1.5 equiv) dropwise at 0° C. The mixture was stirredfor 30 min, and then a solution of acetyl chloride (5.3 mL, 1.5 equiv)in DCM (150 mL) was added at 0° C. and stirred for 1 h at thistemperature. A 5% aq citric acid solution was added at 0° C. and thereaction mixture was stirred for 15 min at rt. The precipitate wascollected by filtration, washed with water, and dried in vacuo to give1-(5-(benzyloxy)-1H-indol-3-yl)ethanone.

tert-Butyl 2-(3-acetyl-5-(benzyloxy)-1H-indol-1-yl)acetate

To a mixture of 1-(5-(benzyloxy)-1H-indol-3-yl)ethanone (6.5 g, 1 equiv)and K₂CO₃ (3.72 g, 1.1 equiv) in acetonitrile (50 mL) was addedtert-butyl 2-bromoacetate (3.92 mL, 1.1 equiv) dropwise at rt. Theresulting mixture was then heated to reflux for 18 h. After cooling tort, the mixture was diluted with DCM (100 mL), and then filtered througha pad of Celite®. The filtrate was concentrated under reduced pressureand the remaining residue was purified by flash column chromatography(silica gel, eluted with DCM/EtOAc) to give tert-butyl2-(3-acetyl-5-(benzyloxy)-1H-indol-1-yl)acetate.

tert-Butyl 2-(3-acetyl-5-hydroxy-1H-indol-1-yl)acetate (Int-3)

To a mixture of tert-butyl2-(3-acetyl-5-(benzyloxy)-1H-indol-1-yl)acetate (6 g) in THF (80 mL) wasadded Pd/C (0.05 equiv). The reaction mixture was stirred at rt for 5 hunder an atmosphere of H₂ (1 atm). The reaction mixture was thenfiltered through a pad of Celite® and washed with DCM and MeOH. Thefiltrate was concentrated under reduced pressure and the remainingresidue was purified by flash column chromatography (silica gel, elutedwith DCM/EtOAc) to give Int-3.

2-(3-Acetyl-5-hydroxy-1H-indol-1-yl)acetic acid (Int-4)

tert-Butyl 2-(3-acetyl-5-hydroxy-1H-indol-1-yl) acetate (Int-3, 814 mg,2.8 mmol) was taken in 4 N HCl in dioxane (10 mL) and the resultingreaction mixture was stirred at rt for 48 h. The solvent was thenremoved under reduced pressure to give Int-4.

1-(6-(Benzyloxy)-1H-indol-3-yl)ethanone

Phosphoryl chloride (103 mL, 10 equiv) was added to ice-colddimethylacetamide (311 mL, 30 equiv) with stirring and cooling in ice.6-Benzyloxy indole (25 g, 1 equiv) was then added and the reactionmixture was stirred at rt for 12 h, then poured over ice and basifiedwith a 4 N aqueous sodium hydroxide solution until a precipitate formed.The solid was collected by filtration, washed with water, and dried. Thesolid was then slurried with methanol, collected by filtration, anddried to give 1-(6-(benzyloxy)-1H-indol-3-yl)ethanone (20 g).

tert-Butyl 2-(3-acetyl-6-(benzyloxy)-1H-indol-1-yl)acetate

To a mixture of 1-(6-(benzyloxy)-1H-indol-3-yl)ethanone (25 g, 1 equiv)and potassium carbonate (11.6 g, 1.1 equiv) in acetonitrile (384 mL) wasadded tert-butyl bromoacetate (12.4 mL, 1.1 equiv) dropwise at rt. Theresulting mixture was heated to reflux for 12 h, allowed to cool to rt,poured into water, and extracted with EtOAc. The combined organicextracts were concentrated under reduced pressure. The resulting solidwas slurried with MTBE, collected by filtration, and dried to givetert-butyl 2-(3-acetyl-6-(benzyloxy)-1H-indol-1-yl)acetate (26 g).

tert-Butyl 2-(3-acetyl-6-hydroxy-1H-indol-1-yl)acetate (Int-5)

A mixture of tert-butyl 2-(3-acetyl-6-(benzyloxy)-1H-indol-1-yl)acetate(22 g, 1 equiv), DCM/MeOH (600 mL), and Pd/C (2.2 g, 10%) was stirred atrt for 12 h under an atmosphere of H₂ (3.5 kg/cm²). The reaction mixturewas filtered through a pad of Celite® and washed with DCM and MeOH. Thefiltrate was evaporated under reduce pressure, and the remaining crudeproduct was slurried with DCM, collected by filtration, and dried togive tert-butyl 2-(3-acetyl-6-hydroxy-1H-indol-1-yl)acetate (11.5 g).

2-(3-Acetyl-6-hydroxy-1H-indol-1-yl)acetic acid (Int-6)

The title compound was prepared in a manner analogous to that describedabove for 2-(3-acetyl-5-hydroxy-1H-indol-1-yl)acetic acid (Int-4, Scheme3).

(2S,4R)-1-(2-(3-Acetyl-6-hydroxy-1H-indol-1-yl)acetyl)-N-(3-chloro-2-fluorobenzyl)-4-fluoropyrrolidine-2-carboxamide(Int-7)

(2S,4R)—N-(3-Chloro-2-fluorobenzyl)-4-fluoropyrrolidine-2-carboxamidehydrochloride Int-2 (2.42 g) and2-(3-acetyl-6-hydroxy-1H-indol-1-yl)acetic acid Int-6 (1.61 g) weredissolved in DMF (40 mL) and treated with HATU (3.56 g) in the presenceof DIEA (4.08 mL) at rt overnight. After the volatiles were removedunder reduced pressure, the residue was purified by columnchromatography using 0-5% MeOH in DCM as eluent to give Int-7 (2.17 g)as a solid.

Diethyl(((3-acetyl-1-(2-((2S,4R)-2-((3-chloro-2-fluorobenzyl)carbamoyl)-4-fluoropyrrolidin-1-yl)-2-oxoethyl)-1H-indol-6-yl)oxy)methyl)phosphonate(7)

(2S,4R)-1-(2-(3-Acetyl-6-hydroxy-1H-indol-1-yl)acetyl)-N-(3-chloro-2-fluorobenzyl)-4-fluoropyrrolidine-2-carboxamideInt-7 (2.1 g), (diethoxyphosphoryl)methyl 4-methylbenzenesulfonate (1.32g), and Cs₂CO₃ (4.2 g) in DMF (21 mL) was stirred overnight at 50° C.The solvent was then removed under reduced pressure and the residue waspurified by column chromatography using 0-15% MeOH in DCM as eluent togive 7 (1.1 g) as a solid. LC (method A): t_(R)=1.84 min. LC/MS (EI)m/z: [M+H]+ calcd for C₂₉H₃₄C₁F₂N₃O₇P, 640. found, 640.

(((3-Acetyl-1-(2-((2S,4R)-2-((3-chloro-2-fluorobenzyl)carbamoyl)-4-fluoropyrrolidin-1-yl)-2-oxoethyl)-1H-indol-6-yl)oxy)methyl)phosphonicacid (8

TMSBr (7 mL) was added todiethyl(((3-acetyl-1-(2-((2s,4r)-2-((3-chloro-2-fluorobenzyl)carbamoyl)-4-fluoropyrrolidin-1-yl)-2-oxoethyl)-1h-indol-6-yl)oxy)methyl)phosphonate7 (1.1 g) in DCM (7 mL). The mixture was stirred at rt for 3 h.Volatiles were removed under reduced pressure and the residue wasco-evaporated with 10% MeOH in DCM (10 mL). The remaining solid waswashed with EtOAc (10 mL) three times to give 8 (1.1 g). ¹H NMR (400MHz, DMSO-d₆, 300 K): (major rotamer) δ 2.33 (s, 3H), 3.96-4.06 (m, 4H),4.22-4.41 (m, 2H), 5.17 (dd, J=75.2, 16.8 Hz, 2H), 5.45 (d, J=52 Hz,1H), 6.82-6.83 (m, 1H), 6.93 (t, J=7.6 Hz, 1H), 7.07 (d, J=2 Hz, 1H),7.19 (t, J=4 Hz, 1H), 7.34 (t, J=6 Hz, 1H), 7.98 (d, J=2.8 Hz, 1H), 8.04(s, 1H), 8.54 (t, J=3 Hz, 1H). LC (method A): t_(R)=1.03 min. LC/MS (EI)m/z: [M+H]+ calcd for C₂₅H₂₆C₁F₂N₃O₇P, 584. found, 584.

(2S,4R)-1-(2-(3-Acetyl-5-hydroxy-1H-indol-1-yl)acetyl)-N-(3-chloro-2-fluorobenzyl)-4-fluoropyrrolidine-2-carboxamide

(2S,4R)—N-(3-Chloro-2-fluorobenzyl)-4-fluoropyrrolidine-2-carboxamidehydrochloride Int-2 (240 mg) and2-(3-acetyl-5-hydroxy-1H-indol-1-yl)acetic acid Int-4 (160 mg) weredissolved in DMF (5 mL) and treated with HATU (360 mg) in the presenceof DIEA (0.4 mL) at rt overnight. After volatiles were removed underreduced pressure, the residue was purified by column chromatographyusing 0-5% MeOH in DCM as eluent to give(2S,4R)-1-(2-(3-acetyl-5-hydroxy-1H-indol-1-yl)acetyl)-N-(3-chloro-2-fluorobenzyl)-4-fluoropyrrolidine-2-carboxamide(200 mg).

Diethyl(((3-acetyl-1-(2-(2S,4R)-2-((3-chloro-2-fluorobenzyl)carbamoyl)-4-fluoropyrrolidin-1-yl)-2-oxoethyl)-1H-indol-5-yl)oxy)methyl)phosphonate(10)

(2S,4R)-1-(2-(3-Acetyl-5-hydroxy-1H-indol-1-yl)acetyl)-N-(3-chloro-2-fluorobenzyl)-4-fluoropyrrolidine-2-carboxamide(100 mg), (diethoxyphosphoryl)methyl 4-methylbenzenesulfonate (1 equiv),and Cs₂CO₃ (200 mg) in DMF was stirred overnight at 50° C. The solventwas removed under reduced pressure and the residue was purified bycolumn chromatography using 0-15% MeOH in DCM as eluent to give 10 (50mg). ¹H NMR (400 MHz, DMSO-d₆, 300 K): (major rotamer) δ 1.28 (t, J=6.8Hz, 6H), 2.00-2.24 (m, 1H), 2.42 (s, 3H), 3.80-3.99 (m, 1H), 4.11-4.18(m, 4H), 4.29-4.49 (m, 5H), 5.25 (dd, J=81, 17 Hz, 2H), 5.50 (d, J=52.8Hz, 1H), 6.92-6.99 (m, 2H), 7.23 (t, J=7.2 Hz, 1H), 7.37-7.44 (m, 2H),7.77 (d, J=2.4 Hz, 1H), 8.21 (s, 1H), 8.58 (t, J=5.6 Hz, 1H). LC (methodA): t_(R)=1.79 min. LC/MS (EI) m/z: [M+H]+ calcd for C₂₉H₃₄C₁F₂N₃O₇P,640. found, 640.

(((((3-Acetyl-1-(2-(2S,4R)-2-((3-chloro-2-fluorobenzyl)carbamoyl)-4-fluoropyrrolidin-1-yl)-2-oxoethyl)-1H-indol-6-yl)oxy)methyl)(hydroxy)phosphoryl)oxy)methylisopropyl carbonate (13)

To a solution of(((3-acetyl-1-(2-((2S,4R)-2-(3-chloro-2-fluorobenzyl)carbamoyl)-4-fluoropyrrolidin-1-yl)-2-oxoethyl)-1H-indol-6-yl)oxy)methyl)phosphonicacid 8 (0.21) in DMF (2 mL), Et₃N (0.16 mL) was added followed bychloromethyl isopropyl carbonate (0.144 mL). The resulting reactionmixture was heated at 60° C. for 16 h. The solvent was removed underreduced pressure after cooling the reaction mixture to rt. The residuewas purified by preparative HPLC (fractions were collected based on UV)to give 13 (50 mg) as a solid. ¹H NMR (400 MHz, CD₃OD, 300 K): (majorrotamer) δ 1.06 (d, J=6.4 Hz, 6H), 1.15-1.23 (m, 1H), 1.99-2.07 (m, 1H),2.39 (s, 3H), 2.46-2.56 (m, 1H), 3.82-4.29 (m, 4H), 4.29-4.39 (m, 2H),4.46-4.55 (m, 1H), 4.64-4.67 (m, 1H), 4.92-4.99 (m, 1H), 5.09-5.17 (m,1H), 5.36 (d, J=52 Hz, 1H), 5.55 (d, J=12.4 Hz, 2H), 6.76-6.81 (m, 2H),6.86 (d, J=8.8 Hz, 1H), 6.97 (d, J=1.6 Hz, 1H), 7.14-7.29 (m, 2H), 7.92(d, J=6 Hz, 1H), 8.02 (d, J=8.8 Hz, 1H); ³¹F NMR (376 MHz, CD₃OD, 300K): (major rotamer) δ −178.6, −123.4. LC (method A): t_(R)=1.38 min.LC/MS (EI) m/z: [M+H]⁺ calcd for C₃₀H₃₄ClF₂N₃O₁₀P, 700. found, 700.

(2S,4R)-1-(2-(3-acetyl-6-((N-(tert-butyl)sulfamoyl)methoxy)-1H-indol-1-yl)acetyl)-N-(3-chloro-2-fluorobenzyl)-4-fluoropyrrolidine-2-carboxamide(15)

A mixture of(2S,4R)-1-(2-(3-acetyl-6-hydroxy-1H-indol-1-yl)acetyl)-N-(3-chloro-2-fluorobenzyl)-4-fluoropyrrolidine-2-carboxamide31 (0.18 g), N-tert-butyl-1-chloromethanesulfonamide (320 mg), andCs₂CO₃ (0.8 g) in DMF (2 mL) was heated at 60° C. for 3 d. The reactionmixture was then cooled to rt and filtered. The solid was washed withDMF. The filtrate was concentrated under reduced pressure and theresidue was purified by column chromatography (0-2% MeOH in DCM) to give15 (60 mg) as a solid. ¹H NMR (400 MHz, CD₃OD, 300 K): (major rotamer) δ1.31 (s, 9H), 2.12-2.28 (m, 1H), 2.52 (s, 3H), 2.54-2.76 (m, 1H),4.10-4.20 (m, 2H), 4.46 (s, 2H), 4.62 (t, J=8 Hz), 5.12 (d, J=11.6 Hz,1H), 5.08-5.14 (m, 2H), 5.27 (d, J=17.2 Hz, 1H), 5.48 (d, J=52.4 Hz,1H), 6.89 (t, J=8 Hz, 1H), 7.05 (dd, J=6.8, 2.0 Hz, 1H), 7.15 (d, J=2.0Hz, 1H), 7.26-7.32 (m, 2H), 8.09 (s, 1H), 8.18 (d, J=8.4 Hz, 1H); ³¹FNMR (376 MHz, CD₃OD, 300 K): (major rotamer) δ −178.5, −123.4. LC(method A): t_(R)=1.83 min. LC/MS (EI) m/z: [M+H]⁺ calcd forC₂₉H₃₄C₁F₂N₄O₆S, 639. found, 639.

Ethyl ethyl(hydroxymethyl)phosphinate

A mixture of ethyl ethylphosphinate (2.2 g), paraformaldehyde (2.7 g),and TEA (10 mL) in DMF (10 mL) was heated at 100° C. for 3 h. Volatileswas removed under reduced pressure. The residue was treated with waterand extracted with choloform. The aqueous layer was concentrated to giveethyl ethyl(hydroxymethyl)phosphinate.

(Ethoxy(ethyl)phosphoryl)methyl 4-bromobenzenesulfonate

Ethyl ethyl(hydroxymethyl)phosphinate from above was mixed with4-bromobenzenesulfonyl chloride (5 g) in DCM (30 mL) and treated withTEA (10 mL) at rt for 4 h. After aqueous workup, the solvent was removedunder reduced pressure and the remaining residue was purified by columnchromatography to give (ethoxy(ethyl)phosphoryl)methyl4-bromobenzenesulfonate (385 mg).

Ethyl(((3-acetyl-1-(2-((2S,4R)-2-((3-chloro-2-fluorobenzyl)carbamoyl)-4-fluoropyrrolidin-1-yl)-2-oxoethyl)-1H-indol-6-yl)oxy)methyl)(ethyl)phosphinate(14)

A mixture of (ethoxy(ethyl)phosphoryl)methyl 4-bromobenzenesulfonate(385 mg),(2S,4R)-1-(2-(3-acetyl-6-hydroxy-1H-indol-1-yl)acetyl)-N-(3-chloro-2-fluorobenzyl)-4-fluoropyrrolidine-2-carboxamideInt-7 (470 mg), and Cs₂CO₃ (1 g) in DMF (20 mL) was stirred at 50° C.overnight. The solvent was removed under reduced pressure and theremaining residue was purified by column chromatography using 5% MeOH inDCM as eluent to give 14 (427 mg). LC (method A): t_(R)=1.40 min. LC/MS(EI) m/z: [M+H]+ calcd for C₂₉H₃₄ClF₂N₃O₆P, 624. found, 624.

(((3-Acetyl-1-(2-((2S,4R)-2-((3-chloro-2-fluorobenzyl)carbamoyl)-4-fluoropyrrolidin-1-yl)-2-oxoethyl)-1H-indol-6-yl)oxy)methyl)(ethyl)phosphinicAcid (16

Ethyl(((3-acetyl-1-(2-((2S,4R)-2-((3-chloro-2-fluorobenzyl)carbamoyl)-4-fluoropyrrolidin-1-yl)-2-oxoethyl)-1H-indol-6-yl)oxy)methyl)(ethyl)phosphinate14 (400 mg) was dissolved in DCM (3 mL) and was treated with TMSBr (3mL) at rt for 2 h. Volatiles were removed under reduced pressure and theresidue was co-evaporated with 10% MeOH in DCM (10 mL). The remainingsolid was washed with EtOAc (10 mL) three times to give 16 (300 mg). ¹HNMR (400 MHz, DMSO-d₆, 300 K): (major rotamer) δ 2.00-2.24 (m, 1H),2.65-2.50 (m, 7H), 2.67 (d, J=4.4 Hz, 1H), 3.89-4.69 (m, 7H), 5.41 (ddd,J=84, 22, 4.4 Hz, 2H), 5.53 (d, J=52.4 Hz, 1H), 6.83-6.88 (m, 1H), 7.20(t, J=7.2 Hz, 1H), 7.38 (t, J=8 Hz, 1H), 7.88 (d, J=8.4 Hz, 1H), 8.04(d, J=5.2 Hz, 1H), 8.30 (d, J=8.4 Hz, 2H), 8.47 (s, 1H), 8.64 (t, J=6Hz, 1H). LC (method A): t_(R)=1.18 min. LC/MS (EI) m/z: [M+H]+ calcd forC₂₇H₃₀ClF₂N₃O₆P, 596. found, 596.

(((((3-Acetyl-1-(2-((2S,4R)-2-((3-chloro-2-fluorobenzyl)carbamoyl)-4-fluoropyrrolidin-1-yl)-2-oxoethyl)-1H-indol-6-yl)oxy)methyl)phosphoryl)bis(oxy))bis(methylene)bis(2,2-dimethylpropanoate) (21)

To a solution of(((3-acetyl-1-(2-((2S,4R)-2-(3-chloro-2-fluorobenzyl)carbamoyl)-4-fluoropyrrolidin-1-yl)-2-oxoethyl)-1H-indol-6-yl)oxy)methyl)phosphonicacid 8 (426 mg) in DMF (7 mL) was added TEA (0.62 mL) followed bychloromethyl pivalate (0.63 mL). After the stirred mixture was heated ina 55° C. oil bath for 24 h, additional chloromethyl pivalate (0.63 mL)and triethylamine (0.62 mL) were added. The reaction was kept at 55° C.for an additional 24 h. The volatiles were removed under reducedpressure and the remaining residue was purified by flash columnchromatography on silica gel with DCM/MeOH as eluent. The desiredfractions were combined, concentrated, and evaporated. The remainingresidue was dissolved in acetonitrile-water and lyophilized to afford 21(216 mg). ¹H NMR (400 MHz, DMSO-d₆, 300 K): (major rotamer) δ 1.13 (s,18H), 2.04-2.15 (m, 1H), 2.40 (s, 3H), 2.48-2.53 (m, 1H), 3.84-3.96 (m,1H), 4.08-4.17 (m, 1H), 4.25-4.52 (m, 5H), 5.11-5.34 (m, 2H), 5.45-5.58(m, 1H), 5.66-5.70 (m, 4H), 6.91-6.99 (m, 2H), 7.15 (s, 1H), 7.24 (t,J=6.8 Hz, 1H), 7.40-7.44 (m, 1H), 8.06 (d, J=8.8 Hz, 1H), 8.14 (s, 1H),8.62 (t, J=6.0 Hz, 1H). ¹⁹F NMR (376 MHz, DMSO-d₆, 300 K): (majorrotamer) δ −121.74, −176.01. ³¹P NMR (162 MHz, DMSO-d₆, 300K): (majorrotamer) δ 19.97. LC (method A): t_(R)=2.58 min. LC/MS (EI) m/z: [M+H]+calcd for C₃₇H₄₆ClF₂N₃O₁₁P, 812. found, 812.

6-((tert-Butyldimethylsilyl)oxy)-1H-indazole

To a solution of 6-hydroxy-1H-indazole (50 g) in DMF (500 mL) were addedimidazole (63.4 g) and TBDMSCl (67.4 g) at 0° C. The reaction mixturewas stirred at rt for 3 h, then poured into water until a precipitateformed. The solid was collected by filtration, washed with water, anddried to give 6-((tert-butyldimethylsilyl)oxy)-1H-indazole (80 g).

6-((tert-Butyldimethylsilyl)oxy)-3-iodo-1H-indazole

To a solution of 6-((tert-butyldimethylsilyl)oxy)-1H-indazole (45 g) inTHF (450 mL) were added iodine (69 g) and potassium tert-butoxide (50.8g) at 0° C. The reaction mixture was stirred at rt for 12 h. The mixturewas diluted with 10% sodium thiosulfate and water, and then extractedwith EtOAc. The combined organic extracts were washed with brine, andthen dried. The residual crude product was purified by columnchromatography to give6-((tert-butyldimethylsilyl)oxy)-3-iodo-1H-indazole (35 g).

tert-Butyl2-(6-((tert-butyldimethylsilyl)oxy)-3-iodo-1H-indazol-1-yl)acetate

To a mixture of 6-((tert-butyldimethylsilyl)oxy)-3-iodo-1H-indazole (10g) and potassium carbonate (9.2 g) in DMF (100 mL) was added tert-butylbromoacetate (4.3 mL) dropwise at rt. The resulting mixture was stirredfor 2 h, poured into water, and extracted with EtOAc. The combinedorganic extracts were concentrated under reduced pressure to givetert-butyl2-(6-((tert-butyldimethylsilyl)oxy)-3-iodo-1H-indazol-1-yl)acetate (11g).

tert-Butyl 2-(6-hydroxy-3-iodo-1H-indazol-1-yl)acetate

To a solution of tert-butyl2-(6-((tert-butyldimethylsilyl)oxy)-3-iodo-1H-indazol-1-yl)acetate (144g) in THF (1440 mL) was added TBAF (1 M solution in THF, 324 mL) at 0°C. and the resulting mixture was stirred at rt for 2 h. The reactionmixture was poured into ice water and extracted with EtOAc; the combinedorganic extracts were concentrated under reduced pressure. The residualcrude product was purified by column chromatography to give tert-butyl2-(6-hydroxy-3-iodo-1H-indazol-1-yl)acetate (75 g).

tert-Butyl 2-(3-cyano-6-hydroxy-1H-indazol-1-yl)acetate

A mixture of tert-butyl 2-(6-hydroxy-3-iodo-1H-indazol-1-yl)acetate (86g), Zn(CN)₂ (29.7 g), Pd (dppf)Cl₂ (16.8 g), Pd₂(dba)₃ (21 g), water (86mL), and DMF (860 mL) was stirred at 80° C. for 3 h under an atmosphereof nitrogen. The reaction mixture was diluted with EtOAc and then washedsuccessively with water, saturated aqueous NaHCO₃, and brine. Thecombined organic layer was concentrated under reduced pressure. Thecrude residue was purified by column chromatography on silica gel(hexanes/EtOAc) to give tert-butyl2-(3-cyano-6-hydroxy-1H-indazol-1-yl)acetate (49 g).

tert-Butyl 2-(3-carbamoyl-6-hydroxy-1H-indazol-1-yl)acetate

A mixture of tert-butyl 2-(3-cyano-6-hydroxy-1H-indazol-1-yl)acetate (49g), acetaldoxime (21.2 g), Pd (OAc)₂ (2 g), and PPh₃ (5 g) in aqueousethanol (H₂O/EtOH 245 mL/980 mL) was heated to reflux for 3 h under anatmosphere of nitrogen. The reaction mixture was filtered throughCelite® and the filtrate was concentrated under reduced pressure. Theremaining crude residue was purified by column chromatography on silicagel (hexanes/EtOAc) to give tert-butyl2-(3-carbamoyl-6-hydroxy-1H-indazol-1-yl)acetate (41 g).

2-(3-Carbamoyl-6-hydroxy-1H-indazol-yl)acetic acid

tert-Butyl 2-(3-carbamoyl-6-hydroxy-1H-indazol-1-yl)acetate (409 mg) wasdissolved in DCM (5 mL) and TFA (5 mL) was added. The reaction mixturewas stirred at rt overnight and then the solvent was removed underreduced pressure to give 2-(3-carbamoyl-6-hydroxy-1H-indazol-1-yl)aceticacid.

1-(2-((2S,4R)-2-((2′-Chloro-2-fluoro-[1,1′-biphenyl]-3-yl)carbomoyl-4-fluoropyrrolidin-1-yl)2-oxoethyl)-6-hydroxy-1H-indazole-3-carboxamide

2-(3-Carbamoyl-6-hydroxy-1H-indazol-1-yl)acetic acid (228 mg) wasdissolved in DMF (10 mL), and DIEA (0.51 mL) was added followed by(2S,4R)—N-(2′-chloro-2-fluoro-[1,1′-biphenyl]-3-yl)-4-fluoropyrrolidine-2-carboxamidehydrochloride (428 mg). HATU (380 mg) was then added slowly and thereaction mixture was stirred for 18 h at rt. After completion of thereaction monitored by HPLC, the reaction mixture was poured into water(15 mL) and extracted with EtOAc (2×25 mL). The organic layer was washedsuccessively with an aqueous solution of NaHCO₃ (15 mL), water (15 mL),and brine (15 mL), then dried over Na₂SO₄ and concentrated under reducedpressure. The remaining residue was purified by column chromatography(eluted with DCM/MeOH) to give1-(2-((2S,4R)-2-((2′-chloro-2-fluoro-[1,1′-biphenyl]-3-yl)carbamoyl)-4-fluoropyrrolidin-1-yl)-2-oxoethyl)-6-hydroxy-1H-indazole-3-carboxamide.

6-((N-(tert-Butyl)sulfamyl)methoxy)-1-(2-((2S,4R)-2-((2′-chloro-2-fluoro-[1,1′-biphenyl]-3-yl)carbomoyl-4-fluoropyrrolidin-1-yl)-2-oxoethyl)-1H-indazole-3-carboxamide(28)

1-(2-((2S,4R)-2-((2′-chloro-2-fluoro-[1,1′-biphenyl]-3-yl)carbamoyl)-4-fluoropyrrolidin-1-yl)-2-oxoethyl)-6-hydroxy-1H-indazole-3-carboxamide(156 mg) was dissolved in DMF (5 mL) and Cs₂CO₃ (456 mg, 5 equiv) wasadded followed by N-tert-butyl-1-chloromethanesulfonamide (260 mg). Thereaction mixture was heated at 55° C. for 2 d. The reaction mixture wasdiluted with EtOAc (10 mL) and water (4 mL). The organic layer wasseparated, washed with brine (15 mL), dried (Na₂SO₄), and concentratedunder reduced pressure. The remaining material was purified bypreparative HPLC (ACN/water/TFA) to give 28. LC (method A): t_(R)=2.22min. LC/MS (EI) m/z: [M+H]+ calcd for C₃₂H₃₄ClF₂N₆O₆S, 703. found, 703.

1-(2-((2S,4R)-2-((2′-Chloro-2-fluoro-[1,1′-biphenyl]-3-yl)carbomoyl-4-fluoropyrrolidin-1-yl)-2-oxoethyl)-6-(sulfamoylmethoxy)-1H-indazole-3-carboxamide(29)

6-((N-(tert-Butyl)sulfamoyl)methoxy)-1-(2-((2S,4R)-2-((2′-chloro-2-fluoro-[1,1′-biphenyl]-3-yl)carbamoyl)-4-fluoropyrrolidin-1-yl)-2-oxoethyl)-1H-indazole-3-carboxamide28 (65 mg) was dissolved in DCM (5 mL) and then TFA (5 mL) was added.The reaction mixture was stirred for 3 d and the volatiles were thenremoved under reduced pressure to give 29. ¹H NMR (400 MHz, DMSO-d₆, 300K): (major rotamer) δ 2.12-2.29 (m, 1H), 3.88-3.92 (m, 1H), 4.16-4.21(m, 2H), 4.75 (t, J=7 Hz, 1H), 5.11-5.19 (m, 2H), 5.36-5.67 (m, 3H),7.01-7.06 (m, 1H), 7.18-7.25 (m, 2H), 7.32-7.53 (m, 4H), 7.56-7.60 (m,1H), 7.95-8.00 (m, 1H), 8.07 (d, J=8.8 Hz, 1H); ¹⁹F NMR (376 MHz,DMSO-d₆, 300 K): (major rotamer) δ −126.96, −175.68. LC (method A):t_(R)=1.80 min. LC/MS (EI) m/z: [M+H]+ calcd for C₂₈H₂₆ClF₂N₆O₆S, 647.found, 647.

tert-Butyl 2-(3-acetyl-6-(pyrimidin-2-yloxy)-1H-indol-1-yl)acetate

A mixture of tert-butyl 2-(3-acetyl-6-hydroxy-1H-indol-1-yl)acetateInt-5 (290 mg), 1-bromo-pyrimidine (1.25 equiv), and K₂CO₃ (3 equiv) wasrefluxed in acetonitrile overnight. The solid was removed by filtrationand washed with EtOAc (20 mL). The filtrate was concentrated and theremaining residue was purified by column chromatography to givetert-butyl 2-(3-acetyl-6-(pyrimidin-2-yloxy)-1H-indol-1-yl)acetate (165mg).

2-(3-Acetyl-6-(pyrimidin-2-yloxy)-1H-indol-1-yl)acetic acid (int-8)

tert-Butyl 2-(3-acetyl-6-(pyrimidin-2-yloxy)-1H-indol-1-yl)acetate (158mg) was treated with TFA (1 mL) in DCM (1 mL) overnight at rt. Thesolvent was removed under reduced pressure and the residue wasco-evaporated with toluene (5 mL) twice. The solid was washed with EtOAc(5 mL) and dried to give Int-8.

(2S,4R)-1-(2-(3-Acetyl-6-(pyrimidin-2-yloxy)-1H-indol-1-yl)acetyl)-N-(3-chloro-2-fluorobenzyl)-4-fluoropyrrolidine-2-carboxamide(30)

A mixture of 2-(3-acetyl-6-(pyrimidin-2-yloxy)-1H-indol-1-yl)acetic acidInt-8 (31 mg) and(2S,4R)—N-(3-chloro-2-fluorobenzyl)-4-fluoropyrrolidine-2-carboxamidehydrochloride Int-2 (1 equiv) in DMF was treated with HATU (1.5 equiv)and DIEA (4 equiv) at rt for 1 h. The volatiles were removed underreduced pressure. The remaining residue was treated with 10% aqueousNa₂CO₃ and extracted with EtOAc. The organic extract was washed withbrine, dried over Na₂SO₄, and evaporated under reduced pressure. Theresidue was purified by column chromatography to give 30 (52.8 mg). ¹HNMR (400 MHz, DMSO-d₆, 300 K): (major rotamer) δ 1.96-2.07 (m, 1H), 2.36(s, 3H), 2.42-2.50 (m, 1H), 3.74-3.87 (m, 1H), 4.02-4.08 (m, 1H),4.18-4.27 (m, 2H), 4.34-4.37 (m, 1H), 5.05-5.30 (m, 2H), 5.34-5.47 (m,1H), 6.92-6.98 (m, 2H), 7.11-7.17 (m, 2H), 7.32-7.38 (m, 2H), 8.10 (d,J=8.8 Hz, 1H), 8.17 (s, 1H), 8.49 (t, J=6.0 Hz, 1H), 8.55 (d, J=4.8 Hz,2H). ¹⁹F NMR (376 MHz, DMSO-d₆, 300 K): (major rotamer) δ −121.28,-176.12. LC (method A): t_(R)=2.54 min. LC/MS (EI) m/z: [M+H]⁺ calcd forC₂₈H₂₅ClF₂N₅O₄, 568. found, 568.

tert-Butyl 2-(3-carbamoyl-5-hydroxy-1H-indazol-1-yl)acetate

The title compound was prepared from 5-hydroxyindole in a manneranalogous to that described above for tert-butyl2-(3-carbamoyl-6-hydroxy-1H-indazol-1-yl)acetate (Scheme 11).

tert-Butyl 2-(3-carbamoyl-5-(pyrimidin-5-yloxy)-1H-indazol-1-yl)acetate

A mixture of tert-butyl 2-(3-carbamoyl-5-hydroxy-1H-indazol-1-yl)acetate(873 mg, 1 equiv), 5-bromopyrimidine (569 mg, 1.2 equiv), cesiumcarbonate (1.95 g, 2 equiv), and DMF (40 mL) was purged with argon in apressure vessel for 5 min, then tris(dibenzylideneacetone)dipalladium(0)(0.01 equiv) and 4,5-bis(diphenylphosphino)-9,9-dimethylxanthene (0.01equiv) were added under argon. The pressure vessel was sealed and heatedat 100° C. for 24 h. The reaction mixture was cooled to rt and thesolvent was removed under reduced pressure. The remaining residue waspurified by column chromatography (eluted with DCM/MeOH) to givetert-butyl 2-(3-carbamoyl-5-(pyrimidin-5-yloxy)-1H-indazol-1-yl)acetate.

2-(3-Carbamoyl-5-(pyrimidin-5-yloxy)-1H-indazol-1-yl)acetic acid

tert-Butyl 2-(3-carbamoyl-5-(pyrimidin-5-yloxy)-1H-indazol-1-yl)acetate(100 mg) was stirred in a 1:1 mixture of DCM-TFA (10 mL) at rt for 4 h.The volatiles were then removed under reduced pressure to give2-(3-carbamoyl-5-(pyrimidin-5-yloxy)-1H-indazol-1-yl)acetic acid. Thismaterial was used directly in the next synthetic step.

1-(2-((2S,4R)-2-02′-Chloro-2-fluoro-[1,1′-biphenyl]-3-yl)carbamoyl)-4-fluoropyrrolidin-1-yl)-2-oxoethyl)-5-(pyrimidin-5-yloxy)-1H-indazole-3-carboxamide(31)

2-(3-Carbamoyl-5-(pyrimidin-5-yloxy)-1H-indazol-1-yl)acetic acid (60 mg,0.191 mmol) from the previous step was dissolved in DMF (10 mL) and DIEA(0.160 mL, 5 equiv) was added, which was followed by the addition of(2S,4R)—N-(2′-chloro-2-fluoro-[1,1′-biphenyl]-3-yl)-4-fluoropyrrolidine-2-carboxamidehydrochloride Int-1 (71 mg, 1 equiv) at 5° C. HATU (153 mg, 2.1 equiv)was then added slowly at the same temperature and the reaction mixturewas stirred for 5 h at rt. After completion of the reaction monitored byHPLC, the reaction mixture was added to water (50 mL+5 g solid NaCl) andextracted with DCM (2×25 mL). The organic layer was washed successivelywith an aqueous solution of NaHCO₃ (20 mL), water (20 mL), and brine (20mL), then dried over Na₂SO₄ and concentrated under reduced pressure. Theremaining residue was purified by column chromatography (eluted withDCM/MeOH) to give 31. ¹H NMR (400 MHz, DMSO-d₆, 300 K): (major rotamer)δ 2.12-2.28 (m, 1H), 2.54-2.62 (m, 1H), 3.61-3.62 (m, 1H), 3.90-4.02 (m,1H), 4.19-4.27 (m, 1H), 4.78 (t, J=8 Hz, 1H), 5.48-5.76 (m, 3H), 7.07(t, J=8 Hz, 1H), 7.22 (t, J=8 Hz, 1H), 7.34-7.59 (m, 7H), 7.69-7.70 (m,1H), 7.97 (t, J=8 Hz, 1H), 8.64 (s, 2H), 9.00 (s, 1H), 9.99 (s 1H); ¹⁹FNMR (376 MHz, DMSO-d₆, 300 K): (major rotamer) δ −126.72, −175.85. LC(method A): t_(R)=2.72 min. LC/MS (EI) m/z: [M+H]+ calcd forC₃₁H₂₅ClF₂N₇O₄, 632. found, 632.

(2S,4R)-1-(2-(3-Acetyl-6-(pyrimidin-2-yloxy)-1H-indol-1-yl)acetyl)-N-(2′-chloro-2-fluoro-[1,1′-biphenyl]-3-yl)-4-fluoropyrrolidine-2-carboxamide(32)

A mixture of 2-(3-acetyl-6-(pyrimidin-2-yloxy)-1H-indol-1-yl)acetic acidInt-8 (65.5 mg) and(2S,4R)—N-(2′-chloro-2-fluoro-[1,1′-biphenyl]-3-yl)-4-fluoropyrrolidine-2-carboxamidehydrochloride Int-1 (78 mg) in DMF (3 mL) was treated with HATU (96 mg)and DIEA (4 equiv) at rt for 1 h. The volatiles were removed underreduced pressure. The residue was treated with 10% aqueous Na₂CO₃ andextracted with EtOAc. The organic extract was washed with brine, driedover Na₂SO₄, and concentrated under reduced pressure. The remainingresidue was purified by column chromatography to give 32 (58.1 mg). ¹HNMR (400 MHz, DMSO-d₆, 300 K): (major rotamer) δ 2.00-2.17 (m, 1H), 2.35(s, 3H), 2.47-2.53 (m, 1H), 3.79-3.92 (m, 1H), 4.03-4.12 (m, 1H), 4.68(t, J=8.8 Hz, 1H), 5.11-5.32 (m, 2H), 5.39-5.52 (m, 1H), 6.95-7.01 (m,2H), 7.12 (t, J=8.0 Hz, 1H), 7.17 (t, J=4.8 Hz, 1H), 7.30-7.41 (m, 4H),7.50-7.52 (m, 1H), 7.86 (t, J=7.2 Hz, 1H), 8.10 (d, J=8.8 Hz, 1H), 8.18(s, 1H), 8.55 (d, J=4.8 Hz, 2H), 9.91 (s, 1H). ¹⁹F NMR (376 MHz,DMSO-d₆, 300 K): (major rotamer) δ −126.71, −175.78. LC (method A):t_(R)=2.57 min. LC/MS (EI) m/z: [M+H]⁺ calcd for C₃₃H₂₇ClF₂N₅O₄, 630.found, 630.

tert-Butyl2-(3-acetyl-5-((5-bromopyrimidin-2-yl)oxy)-1H-indol-1-yl)acetate

A mixture of tert-butyl 2-(3-acetyl-5-hydroxy-1H-indol-1-yl)acetate 24(700 mg), 5-bromo-2-fluoropyrimidine (1 equiv), and Cs₂CO₃ (700 mg) inDMF (20 mL) was purged with argon in a pressure vessel for 5 min, thentris(dibenzylideneacetone)dipalladium(0) (0.01 equiv) and4,5-bis(diphenylphosphino)-9,9-dimethylxanthene (0.01 equiv) were addedunder argon. The pressure vessel was sealed and heated at 100° C. for 24h. The reaction mixture was cooled to rt and the solvent was removedunder reduced pressure. The remaining residue was purified by columnchromatography (eluted with DCM/MeOH) to give tert-butyl2-(3-acetyl-5-((5-bromopyrimidin-2-yl)oxy)-1H-indol-1-yl)acetate (700mg).

2-(3-Acetyl-5-((5-bromopyrimidin-2-yl)oxy)-1H-indol-1-yl)acetic acid(Int-9)

tert-Butyl2-(3-acetyl-5-((5-bromopyrimidin-2-yl)oxy)-1H-indol-1-yl)acetate (150mg) was treated with TFA (10 ml) in DCM (10 mL) at rt for 3 h. Thesolvent was removed under reduced pressure to give Int-9.

(2S,4R)-1-(2-(3-Acetyl-5-((5-bromopyrimidin-2-yl)oxy)-1H-indol-1-yl)acetyl)-N-(2′-chloro-2-fluoro-[1,1′-biphenyl]-3-yl)-4-fluoropyrrolidine-2-carboxamide(33)

A mixture of2-(3-acetyl-5-((5-bromopyrimidin-2-yl)oxy)-1H-indol-1-yl)acetic acidInt-9 and(2S,4R)—N-(2′-chloro-2-fluoro-[1,1′-biphenyl]-3-yl)-4-fluoropyrrolidine-2-carboxamidehydrochloride Int-1 (150 mg) in DMF (10 mL) was treated with HATU (325mg) and DIEA (4 equiv) at rt for 1 h. The reaction mixture was pouredinto water. The solid was collected by filtration and then purified bycolumn chromatography using MeOH in DCM as eluent to give 33 (110 mg).¹H NMR (400 MHz, DMSO-d₆, 300 K): (major rotamer) δ 2.10-2.27 (m, 1H),2.4 (s, 3H), 2.51-2.56 (m, 1H), 3.92-4.04 (m, 1H), 4.13-4.25 (m, 1H),4.78 (t, J=8.8 Hz, 1H), 5.35 (dd, J=69, 17, 2H), 5.06 (d, J=56 Hz, 1H),7.04-7.10 (m, 2H), 7.22 (t, J=8.0 Hz, 1H), 7.37-7.51 (m, 4H), 7.57 (d,J=6 Hz, 1H), 7.89 (d, J=2 Hz, 1H), 7.97 (t, J=6 Hz, 1H), 8.31 (s, 1H),8.77 (s, 2H), 9.96 (s, 1H). LC (method A): t_(R)=2.45 min. LC/MS (EI)m/z: [M+H]⁺ calcd for C₃₃H₂₆BrClF₂N₅O₄, 708. found, 708.

(1R,3S,5R)-tert-Butyl3-((2′-chloro-2-fluoro-[1,1′-biphenyl]-3-yl)carbamoyl)-2-azabicyclo[3.1.0]hexane-2-carboxylate

To an ice-cold solution of(1R,3S,5R)-2-(tert-butoxycarbonyl)-2-azabicyclo[3.1.0]hexane-3-carboxylicacid (5 mmol) in DCM (20 mL) was added1-chloro-N,N,2-trimethylpropenylamine (1.1 equiv) dropwise withstirring. The stirring was continued for 3 h at this temperature, thensolid 2′-chloro-2-fluoro-[1,1′-biphenyl]-3-amine hydrochloride (1.0equiv) was added, followed by DIEA (2.5 equiv). The cooling bath wasremoved and the reaction mixture was stirred overnight at rt. Aftercompletion of the reaction (monitored by HPLC), the reaction mixture wasadded to water (20 mL) and extracted with DCM (2×25 mL). The organiclayer was washed successively with an aqueous solution of NaHCO₃ (20mL), water (20 mL), and brine (20 mL), then dried over Na₂SO₄ andconcentrated under reduced pressure. The remaining residue was purifiedby flash column chromatography (eluted with MeOH/DCM) to give(1R,3S,5R)-tert-butyl3-((2′-chloro-2-fluoro-[1,1′-biphenyl]-3-yl)carbamoyl)-2-azabicyclo[3.1.0]hexane-2-carboxylate.

(1R,3S,5R)—N-(2′-Chloro-2-fluoro-[1,1′-biphenyl]-3-yl)-2-azabicyclo[3.1.0]hexane-3-carboxamidehydrochloride

(1R,3S,5R)-tert-Butyl3-((2′-chloro-2-fluoro-[1,1′-biphenyl]-3-yl)carbamoyl)-2-azabicyclo[3.1.0]hexane-2-carboxylate(500 mg) was taken in 4 N HCl in dioxane (25 mL) and the resultingreaction mixture was stirred at rt for 3 h. After completion of thereaction (monitored by HPLC), the solvent was removed under reducedpressure to give(1R,3S,5R)—N-(2′-chloro-2-fluoro-[1,1′-biphenyl]-3-yl)-2-azabicyclo[3.1.0]hexane-3-carboxamidehydrochloride.

(1R,3S,5R)-2-(2-(3-Acetyl-5-((5-bromopyrimidin-2-yl)oxy)-1H-indol-1-yl)acetyl)-N-(2′-chloro-2-fluoro-[1,1′-biphenyl]-3-yl)-2-azabicyclo[3.1.0]hexane-3-carboxamide(34)

A mixture of2-(3-acetyl-5-((5-bromopyrimidin-2-yl)oxy)-1H-indol-1-yl)acetic acidInt-9 (100 mg) and (1R,3S,5R)—N-(2′-chloro-2-fluoro-[1,1′-biphenyl]-3-yl)-2-azabicyclo[3.1.0]hexane-3-carboxamidehydrochloride (1.0 equiv)) in DMF (10 mL) was treated with HATU (2.0equiv) and DIEA (5.0 equiv) at rt for 1 h. The reaction mixture waspoured into water. The solid was collected by filtration and thenpurified by column chromatography using 0-50% of EtOAc in DCM as eluentto give 34 (70 mg). ¹H NMR (400 MHz, DMSO-d₆, 300 K): (major rotamer) δ0.77-0.78 (m, 1H), 1.07-1.09 (m 1H), 1.92 (br s, 1H), 2.42 (s, 3H),2.51-2.56 (m, 1H), 3.81 (br s, 1H), 4.55 (t, J=6.8 Hz, 1H), 5.36 (d,J=17, H), 5.59 (d, J=17 Hz, 1H), 7.03-7.10 (m, 2H), 7.24 (t, J=8.0 Hz,1H), 7.37-7.45 (m, 3H), 7.51-7.58 (m, 2H), 7.89 (d, J=2 Hz, 1H), 7.93(t, J=7.6 Hz, 1H), 8.37 (s, 1H), 8.77 (s, 2H), 9.73 (s, 1H). LC (methodA): t_(R)=2.58 min. LC/MS (EI) m/z: [M+H]⁺ calcd for C₃₄H₂₇BrClFN₅O₄,703. found, 703.

Example 7 Non-Limiting Examples of Compounds of Formula I

Table 1 shows illustrative compounds of Formula I with characterizingdata. The assay of Example 8 was used to determine the IC₅₀'s of thecompounds. Other standard factor D inhibition assays are also available.Three ***s are used to denote compounds with an IC₅₀ less than 1micromolar; two **s indicate compound with an IC₅₀ between 1 micromolarand 10 micromolar, and one * denotes compounds with an IC₅₀ greater than10 micromolar.

TABLE 1 RT min Cmp (Method MS No. Structure Name IC₅₀ A or B) (M + 1) 1

(2S,4R)-1-(2-(3-acetyl-6- (cyclopropylmethoxy)- 1H-indol-1-yl)acetyl)-N-(3-chloro-2-fluorobenzyl)-4- fluoropyrrolidine-2- carboxamide *** 2.14(A) 544 2

3-acetyl-1-(2-((2S,4R)-2-(3- chloro-2- fluorobenzylcarbamoyl)-4-fluoropyrrolidin-1-yl)-2- oxoethyl)-1H-indol-6-yltrifluoromethanesulfonate *** 2.24 (A) 622 3

(1R,3S,5R)-2-(2-(3-acetyl-6- (cyclopropylmethoxy)-1H-indol-1-yl)acetyl)-N-(3- chloro-2-fluorobenzyl)-2-azabicyclo[3.1.0]hexane-3- carboxamide *** 1.46 (A) 538 4

(2S,4R)-1-(2-(3-acetyl-6- (cyclopropylmethoxy)-1H-indol-1-yl)acetyl)-4-fluoro- N-(2-fluoro-3- (trifluoromethoxy)phen-yl)pyrrolidine-2-carboxamide *** 1.66 (A) 580 5

(2S,4R)-1-(2-(3-acetyl-6-(2- cyclopropylethoxy)-1H-indol-1-yl)acetyl)-N-(3- chloro-2-fluorobenzyl)-4- fluoropyrrolidine-2-carboxamide *** 1.70 (A) 558 6

(2S,4R)-1-(2-(3-acetyl-6- ((tricyclo[8.2.2.2^(4,7)]hex-adeca-4,6,10,12,13,15- hexaen-5-ylmethyl)oxy)-1H-indol-1-yl)acetyl)-N-(3- chloro-2-fluorobenzyl)-4- fluoropyrrolidine-2-carboxamide ** 2.25 (A) 710 7

diethyl (3-acetyl-1-(2- ((2S,4R)-2-(3-chloro-2- fluorobenzylcarbamoyl)-4-fluoropyrrolidin-1-yl)- 2-oxoethyl)-1H-indol-6-yloxy)methylphosphonate *** 1.84 (A) 640 8

(3-acetyl-1-(2-((2S,4R)- 2-(3-chloro-2- fluorobenzylcarbamoyl)-4-fluoropyrrolidin-1-yl)- 2-oxoethyl)-1H-indol-6- yloxy)methylphosphonicacid *** 1.03 (A) 584 9

3-acetyl-1-(2-((2S,4R)-2- (3-chloro-2- fluorobenzylcarbamoyl)-4-fluoropyrrolidin-1-yl)-2- oxoethyl)-1H-indol-5-yltrifluoromethanesulfonate *** 2.37 (A) 622 10

diethyl (3-acetyl-1-(2- ((2S,4R)-2-(3-chloro-2- fluorobenzylcarbamoyl)-4-fluoropyrrolidin-1- yl)-2-oxoethyl)-1H-indol-5-yloxy)methylphosphonate *** 1.79 (A) 640 11

(3-acetyl-1-(2-((2S,4R)- 2-(3-chloro-2- fluorobenzylcarbamoyl)-4-fluoropyrrolidin-1-yl)- 2-oxoethyl)-1H-indol-5- yloxy)methylphosphonicacid *** 1.02 (A) 584 12

(((3-acetyl-1-(2- ((2S,4R)-2-(3-chloro-2- fluorobenzylcarbamoyl)-4-fluoropyrrolidin-1-yl)- 2-oxoethyl)-1H-indol-6- yloxy)methyl)phospho-ryl)bis(oxy)bis(methylene) isopropyl dicarbonate *** 2.16 (A) 816 13

(((3-acetyl-1-(2-((2S,4R)- 2-(3-chloro-2- fluorobenzylcarbamoyl)-4-fluoropyrrolidin-1-yl)- 2-oxoethyl)-1H-indol-6- yloxy)methyl)(hydro-xy)phosphoryloxy)meth- yl isopropyl carbonate *** 1.38 (A) 700 14

ethyl (3-acetyl-1-(2- ((2S,4R)-2-(3-chloro-2- fluorobenzylcarbamoyl)-4-fluoropyrrolidin-1-yl)- 2-oxoethyl)-1H-indol- 6-yloxy)methyl(eth-yl)phosphinate *** 1.40 (A) 624 15

(2S,4R)-1-(2-(3-acetyl-6-(N- tert-butylsulfamoylmethoxy)-1H-indol-1-yl)acetyl)-N-(3- chloro-2-fluorobenzyl)-4-fluoropyrrolidine-2- carboxamide *** 1.83 (A) 639 16

(3-acetyl-1-(2-((2S,4R)-2- (3-chloro-2- fluorobenzylcarbamoyl)-4-fluoropyrrolidin-1-yl)-2- oxoethyl)-1H-indol-6- yloxy)methyl(eth-yl)phosphinic acid *** 1.18 (A) 596 17

(2S,4R)-1-(2-(3-acetyl-6- (sulfamoylmethoxy)- 1H-indol-1-yl)acetyl)-N-(3-chloro-2-fluorobenzyl)-4- fluoropyrrolidine-2- carboxamide *** 1.19(A) 583 18

diethyl (3-acetyl-1-(2- ((2S,4R)-2-((R)-1-(3- chloro-2-fluorophen-yl)ethylcarbamoyl)-4- fluoropyrrolidin-1-yl)- 2-oxoethyl)-1H-indol-6-yloxy)methylphosphonate *** 1.67 (A) 654 19

(3-acetyl-1-(2-((2S,4R)- 2-((R)-1-(3-chloro-2- fluorophenyl)ethyl-carbamoyl)-4- fluoropyrrolidin-1-yl)-2- oxoethyl)-1H-indol-6-yloxy)methylphosphonic acid *** 0.22 (A) 598 20

3-(hexadecyloxy)propyl hydrogen (3-acetyl-1-(2- ((2S,4R)-2-(3-chloro-2-fluorobenzylcarbamoyl)- 4-fluoropyrrolidin-1-yl)-2-oxoethyl)-1H-indol-6- yloxy)methylphosphonate *** 3.31 (A) 866 21

(((3-acetyl-1-(2- ((2S,4R)-2-(3-chloro-2- fluorobenzylcarbamoyl)-4-fluoropyrrolidin-1-yl)- 2-oxoethyl)-1H-indol-6- yloxy)methyl)phosph-oryl)bis(oxy)bis(meth- ylene) bis(2,2- dimethylpropanoate) *** 2.58 (A)812 22

(3-acetyl-1-(2-((2S,4R)- 2-((3-chloro-2-fluoro- phenylsulfonamido)meth-yl)-4-fluoropyrrolidin-1- yl)-2-oxoethyl)-1H-indol-6-yloxy)methylphosphonic acid *** 1.11 (A) 620 23

1,1′-(((3-acetyl-1-(2- ((2S,4R)-2-(3-chloro-2- fluorobenzylcarbamoyl)-4-fluoropyrrolidin-1-yl)- 2-oxoethyl)-1H-indol-6- yloxy)methyl)phosph-oryl)bis(oxy)bis(2- methylpropane-1,1-diyl) dipropionate *** 2.79 (A)840 24

(2S,2′S)-isopropyl 2,2′- (((3-acetyl-1-(2-((2S,4R)- 2-(3-chloro-2-fluorobenzylcarbamoyl)- 4-fluoropyrrolidin-1-yl)-2-oxoethyl)-1H-indol-6- yloxy)methyl)phosph- oryl)bis(azanediyl)di-propanoate *** 2.20 (A) 810 25

(3-acetyl-1-(2-((2S,4R)-4- fluoro-2-(3-fluoro-4- (trifluoromethoxy)phen-ylcarbamoyl)pyrrolidin-1- yl)-2-oxoethyl)-1H-indol-6-yloxy)methylphosphonic acid *** 1.46 (A) 620 26

(3-acetyl-1-(2-((2S,4R)-4- fluoro-2-(3-phenoxy-phenylcarbamoyl)pyrrolidin- 1-yl)-2-oxoethyl)-1H-indol-6-yloxy)methylphosphonic acid *** 1.51 (A) 610 27

(3-acetyl-1-(2-((2S,4R)- 4-fluoro-2-(2-fluoro-3-(trifluoromethoxy)phenyl- carbamoyl)pyrrolidin-1-yl)-2-oxoethyl)-1H-indol- 6-yloxy)methylphosphonic acid *** 1.34 (A) 62028

6-(N-tert- butylsulfamoylmethoxy)- 1-(2-((2S,4R)-2-(2′-chloro-2-fluorobiphenyl-3- ylcarbamoyl)-4- fluoropyrrolidin-1-yl)-2-oxoethyl)-1H-indazole-3- carboxamide *** 2.22 (A) 703 29

1-(2-((2S,4R)-2-(2′-chloro- 2-fluorobiphenyl-3- ylcarbamoyl)-4-fluoropyrrolidin-1-yl)-2- oxoethyl)-6- (sulfamoylmethoxy)-1H-indazole-3-carboxamide *** 1.80 (A) 647 30

(2S,4R)-1-(2-(3-acetyl-6- (pyrimidin-2-yloxy)-1H-indol-1-yl)acetyl)-N-(3- chloro-2-fluorobenzyl)-4- fluoropyrrolidine-2-carboxamide *** 2.54 (A) 568 31

1-(2-((2S,4R)-2-(2′-chloro- 2-fluorobiphenyl-3- ylcarbamoyl)-4-fluoropyrrolidin-1-yl)-2- oxoethyl)-5-(pyrimidin-5-yloxy)-1H-indazole-3- carboxamide *** 2.72 (A) 632 32

(2S,4R)-1-(2-(3-acetyl-6- (pyrimidin-2-yloxy)-1H-indol-1-yl)acetyl)-N-(2′- chloro-2-fluorobiphenyl-3-yl)-4-fluoropyrrolidine-2- carboxamide *** 2.57 (A) 630 33

(2S,4R)-1-(2-(3-acetyl-5-(5- bromopyrimidin-2-yloxy)-1H-indol-1-yl)acetyl)-N-(2′- chloro-2-fluorobiphenyl-3-yl)-4-fluoropyrrolidine-2- carboxamide *** 2.45 (A) 708 34

(1R,3S,5R)-2-(2-(3-acetyl-5- (5-bromopyrimidin-2-yloxy)-1H-indol-1-yl)acetyl)-N-(2′- chloro-2-fluorobiphenyl-3-yl)-2-azabicyclo[3.1.0]hex- ane-3-carboxamide *** 2.58 (A) 703 35

(2S,4R)-1-(2-(3-acetyl-5-(5- bromopyrimidin-2-yloxy)-1H-indol-1-yl)acetyl)-N-(6- bromopyridin-2-yl)-4- fluoropyrrolidine-2-carboxamide *** 2.04 (A) 660 36

(2S,4R)-1-(2-(3-acetyl-5-(2- cyanopyrimidin-5-yloxy)-1H-indol-1-yl)acetyl)-N-(2′- chloro-2-fluorobiphenyl-3-yl)-4-fluoropyrrolidine-2- carboxamide *** 2.46 (A) 655 37

(2S,4R)-1-(2-(3-acetyl-5-(5- fluoropyrimidin-2-yloxy)-1H-indol-1-yl)acetyl)-N-(2′- chloro-2-fluorobiphenyl-3-yl)-4-fluoropyrrolidine-2- carboxamide *** 2.31 (A) 648 38

(2S,4R)-1-(2-(3-acetyl-5- (pyrimidin-2-yloxy)-1H-indol-1-yl)acetyl)-N-(2′- chloro-2-fluorobiphenyl-3-yl)-4-fluoropyrrolidine-2- carboxamide *** 2.14 (A) 630 39

(2S,4R)-1-(2-(3-acetyl-5- (pyrimidin-2-yloxy)-1H-indol-1-yl)acetyl)-N-(6- bromopyridin-2-yl)-4- fluoropyrrolidine-2-carboxamide *** 1.63 (A) 581 40

(2S,4R)-1-(2-(3-acetyl-5-(5- methylpyrimidin-2-yloxy)-1H-indol-1-yl)acetyl)-N-(2′- chloro-2-fluorobiphenyl-3-yl)-4-fluoropyrrolidine-2- carboxamide *** 2.26 (A) 644 41

(2S,4R)-1-(2-(3-acetyl-5-(5- methylpyrimidin-2-yloxy)-1H-indol-1-yl)acetyl)-N-(6- bromopyridin-2-yl)-4- fluoropyrrolidine-2-carboxamide *** 1.78 (A) 595 42

(2S,4R)-1-(2-(3-acetyl-5-(5- (trifluoromethyl)pyrimidin-2-yloxy)-1H-indol-1- yl)acetyl)-N-(2′-chloro-2- fluorobiphenyl-3-yl)-4-fluoropyrrolidine- 2-carboxamide *** 2.58 (A) 698 43

(2S,4R)-1-(2-(3-acetyl-5-(2- chloropyrimidin-5-yloxy)-1H-indol-1-yl)acetyl)-N-(2′- chloro-2-fluorobiphenyl-3-yl)-4-fluoropyrrolidine-2- carboxamide *** 2.50 (A) 664

Example 8 Human Factor D Assay

Human factor D (purified from human serum, Complement Technology, Inc.)at 80 nM final concentration is incubated with test compound at variousconcentrations for 5 minutes at room temperature in 50 mM Tris, 1M NaCl,pH 7.5. A synthetic substrate Z-L-Lys-SBzl and DTNB (Ellman's reagent)are added to final concentrations of 100 μM each. The increase in coloris recorded at OD₄₀₅ nm in a microplate in kinetic mode over 30 minuteswith 30 second time points in a spectrofluorimeter. IC₅₀ values arecalculated by non-linear regression from the percentage of inhibition ofcomplement factor D activity as a function of test compoundconcentration.

Example 9 Hemolysis Assay

The hemolysis assay was previously described by G. Ruiz-Gomez, et al.,J. Med. Chem. (2009) 52: 6042-6052. In the assay red blood cells (RBC),rabbit erythrocytes (purchased from Complement Technologies), are washedusing GVB Buffer (0.1% gelatin, 5 mM Veronal, 145 mM NaCl, 0.025% NaN₃,pH 7.3) plus 10 mM final Mg-EGTA. Cells are used at a concentration of1×10⁸ cells/mL. Prior to the hemolysis assay, the optimum concentrationof Normal Human Serum (NHS) needed to achieve 100% lysis of rabbiterythrocytes is determined by titration. NHS (Complement Technologies)is incubated with inhibitor for 15 min at 37° C., rabbit erythrocytes inbuffer were added and incubated for an additional 30 min at 37° C.Positive control (100% lysis) consists of serum and RBC and negativecontrol (0% lysis) of Mg-EGTA buffer and RBC only. Samples arecentrifuged at 2000 g for 5 min, and supernatants collected. Opticaldensity of the supernatant is monitored at 405 nm using a UV/visiblespectrophotometer. Percentage lysis in each sample is calculatedrelative to positive control (100% lysis).

This specification has been described with reference to embodiments ofthe invention. However, one of ordinary skill in the art appreciatesthat various modifications and changes can be made without departingfrom the scope of the invention as set forth in the claims below.Accordingly, the specification is to be regarded in an illustrativerather than a restrictive sense, and all such modifications are intendedto be included within the scope of invention.

1. A compound of Formula I

and the pharmaceutically acceptable salts thereof, wherein: Q¹ is N(R¹)or C(R¹R^(1′)); Q² is C(R²R^(2′)), C(R²R^(2′))—C(R²R^(2′)), S, O, N(R²)or C(R²R^(2′))O; Q³ is N(R³), S, or C(R³R^(3′)); X¹ and X² areindependently N or CH, or X¹ and X² together are C≡C; R¹, R^(1′), R²,R^(2′), R³, and R^(3′) are independently chosen from hydrogen, halogen,hydroxyl, nitro, cyano, amino, C₁-C₆alkyl, C₂-C₆alkenyl, C₂-C₆alkynyl,C₁-C₆alkoxy, C₂-C₆alkynyl, C₂-C₆alkanoyl, C₁-C₆thioalkyl,hydroxyC₁-C₆alkyl, aminoC₁-C₆alkyl, —C₀-C₄alkylNR⁹R¹⁰, —C(O)OR⁹,—OC(O)R⁹, —NR⁹C(O)R¹⁰, —C(O)NR⁹R¹⁰, —OC(O)NR⁹R¹⁰, —NR⁹C(O)OR¹⁰,C₁-C₂haloalkyl, and C₁-C₂haloalkoxy, where R⁹ and R¹⁰ are independentlychosen at each occurrence from hydrogen, C₁-C₆alkyl,(C₃-C₇cycloalkyl)C₀-C₄alkyl, —C₀-C₄alkyl(C₃-C₇cycloalkyl), and—O—C₀-C₄alkyl(C₃-C₇cycloalkyl); A is a group selected from:

each of which R⁴ other than hydrogen, —CHO, and —CONH₂, is unsubstitutedor substituted with one or more of amino, imino, halogen, hydroxyl,cyano, cyanoimino, C₁-C₂alkyl, C₁-C₂alkoxy, —C₀-C₂alkyl(mono- anddi-C₁-C₄alkylamino), C₁-C₂haloalkyl, and C₁-C₂haloalkoxy; R⁵ and R⁶ areindependently selected from —CHO, —C(O)NH₂, —C(O)NH(CH₃), C₂-C₆alkanoyl,hydrogen, hydroxyl, halogen, cyano, nitro, —COOH, —SO₂NH₂, vinyl,C₁-C₆alkyl (including methyl), C₂-C₆alkenyl, C₁-C₆alkoxy,—C₀-C₄alkyl(C₃-C₇cycloalkyl), —C(O)C₀-C₄alkyl(C₃-C₇cycloalkyl),—P(O)(OR⁹)₂, —OC(O)R⁹, —C(O)OR⁹,)—C(O)N(CH₂CH₂R⁹)(R¹⁰, —NR⁹C(O)R¹⁰,phenyl, or 5- to 6-membered heteroaryl; and wherein each R⁵ and R⁶ otherthan hydrogen, hydroxyl, cyano, and —COOH is unsubstituted or optionallysubstituted; R^(6′) is hydrogen, halogen, hydroxyl, C₁-C₄alkyl,—C₀-C₄alkyl(C₃-C₇cycloalkyl), or C₁-C₄alkoxy; or R⁶ and R^(6′) may betaken together to form an oxo, vinyl, or imino group; R⁷ is hydrogen,C₁-C₆alkyl, or —C₀-C₄alkyl(C₃-C₇cycloalkyl); R⁸ and R^(8′) areindependently chosen from hydrogen, halogen, hydroxyl, C₁-C₆alkyl,—C₀-C₄alkyl(C₃-C₇cycloalkyl), C₁-C₆alkoxy, and(C₁-C₄alkylamino)C₀-C₂alkyl; or R⁸ and R^(8′) are taken together to forman oxo group; or R⁸ and R^(8′) can be taken together with the carbonthat they are bonded to form a 3-membered carbocyclic ring; R¹⁶ isabsent or may include one or more substituents independently chosen fromhalogen, hydroxyl, nitro, cyano, C₁-C₆alkyl, C₂-C₆alkenyl,C₂-C₆alkanoyl, C₁-C₆alkoxy, —C₀-C₄alkyl(mono- and di-C₁-C₆alkylamino),—C₀-C₄alkyl(C₃-C₇cycloalkyl), C₁-C₂haloalkyl, and C₁-C₂haloalkoxy; R¹⁹is hydrogen, C₁-C₆alkyl, C₂-C₆alkenyl, C₂-C₆alkanoyl, —SO₂C₁-C₆alkyl,(mono- and di-C₁-C₆alkylamino)C₁-C₄alkyl, —C₀-C₄alkyl(C₃-C₇cycloalkyl),—C₀-C₄alkyl(C₃-C₇heterocycloalkyl), —C₀-C₄alkyl(aryl),C₀-C₄alkyl(heteroaryl), and wherein R¹⁹ other than hydrogen isunsubstituted or substituted with one or more substituents independentlychosen from halogen, hydroxyl, amino, —COOH, and —C(O)OC₁-C₄alkyl; X¹¹is N or CR¹¹; X¹² is N or CR¹²; X¹³ is N or CR¹³; X¹⁴ is N or CR¹⁴, andwherein no more than two of X¹¹, X¹², X¹³, and X¹⁴ are N; one of R¹² andR¹³ is chosen from R³¹ and the other of R¹² and R¹³ is chosen from R³²:R³¹ is chosen from hydrogen, halogen, hydroxyl, nitro, cyano, amino,—COOH, C₁-C₂haloalkyl, C₁-C₂haloalkoxy, C₁-C₆alkyl,—C₀-C₄alkyl(C₃-C₇cycloalkyl), C₂-C₆alkenyl, C₂-C₆alkanoyl, C₁-C₆alkoxy,C₂-C₆alkenyloxy, —C(O)OR⁹, C₁-C₆thioalkyl, —C₀-C₄alkylNR⁹R¹⁰,—C(O)NR⁹R¹⁰, —SO₂R⁹, —SO₂NR⁹R¹⁰, —OC(O)R⁹, and —C(NR⁹)NR⁹R¹⁰, each ofwhich R³¹ other than hydrogen, halogen, hydroxyl, nitro, cyano,C₁-C₂haloalkyl, and C₁-C₂haloalkoxy is unsubstituted or substituted withone or more substituents independently selected from halogen, hydroxyl,nitro, cyano, amino, —COOH, —CONH₂ C₁-C₂haloalkyl, and C₁-C₂haloalkoxy,and each of which R³¹ is also optionally substituted with onesubstituent chosen from phenyl and 4- to 7-membered heterocyclecontaining 1, 2, or 3 heteroatoms independently chosen from N, O, and S;which phenyl or 4- to 7-membered heterocycle is unsubstituted orsubstituted with one or more substituents independently chosen fromhalogen, hydroxyl, nitro, cyano, C₁-C₆alkyl, C₂-C₆alkenyl,C₂-C₆alkanoyl, C₁-C₆alkoxy, (mono- and di-C₁-C₆alkylamino)C₀-C₄alkyl,C₁-C₆alkylester, —C₀-C₄alkyl)(C₃-C₇cycloalkyl), C₁-C₂haloalkyl, andC₁-C₂haloalkoxy; R³² is chosen from —O(CH₂)₁₋₄R^(23a),—OC₂-C₄alkenylR^(23a), —OC₂-C₄alkynylR²³, —O(CH₂)₁₋₄paracyclophane,—O(CH₂)₁₋₄P(O)R^(23b)R^(23b), —O(CH₂)₁₋₄S(O)NR²¹R²²,—O(CH₂)₁₋₄S(O)NR²⁴R²⁵, —O(CH₂)₁₋₄SO₂NR²¹R²², —O(CH₂)₁₋₄SO₂NR²⁴R²⁵,—O(C₃-C₇cycloalkyl), —O(aryl), —O(heteroaryl), and —O(heterocycle) andeach group can be optionally substituted as further described herein.R¹¹, R¹⁴, and R¹⁵ are independently chosen at each occurrence fromhydrogen, halogen, hydroxyl, nitro, cyano, —O(PO)(OR⁹)₂, —(PO)(OR⁹)₂,C₁-C₆alkyl, C₂-C₆alkenyl, C₂-C₆alkynyl, C₂-C₆alkanoyl, C₁-C₆alkoxy,C₁-C₆thioalkyl, —C₀-C₄alkyl(mono- and di-C₁-C₆alkylamino),—C₀-C₄alkyl(C₃-C₇cycloalkyl), —C₀-C₄alkoxy(C₃-C₇cycloalkyl),C₁-C₂haloalkyl, and C₁-C₂haloalkoxy; R²¹ and R²² are independentlychosen at each occurrence from hydrogen, hydroxyl, cyano, amino,C₁-C₆alkyl, C₁-C₆haloalkyl, C₁-C₆alkoxy, (C₃-C₇cycloalkyl)C₀-C₄alkyl,(phenyl)C₀-C₄alkyl, —C₁-C₄alkylOC(O)OC₁-C₆alkyl,—C₁-C₄alkylOC(O)C₁-C₆alkyl, —C₁-C₄alkylC(O)OC₁-C₆alkyl, (4- to7-membered heterocycloalkyl)C₀-C₄alkyl having 1, 2, or 3 heteroatomsindependently chosen from N, O, and S, and (5- or 6-membered unsaturatedor aromatic heterocycle)C₀-C₄alkyl having 1, 2, or 3 heteroatomsindependently chosen from N, O, and S, and each R²¹ and R²² can beoptionally substituted; R²³ is independently chosen at each occurrencefrom C₁-C₆alkyl, C₁-C₆haloalkyl, (aryl)C₀-C₄alkyl,(C₃-C₇cycloalkyl)C₀-C₄alkyl, (phenyl)C₀-C₄alkyl, (4- to 7-memberedheterocycloalkyl)C₀-C₄alkyl having 1, 2, or 3 heteroatoms independentlychosen from N, O, and S, and (5- or 6-membered unsaturated or aromaticheterocycle)C₀-C₄alkyl having 1, 2, or 3 heteroatoms independentlychosen from N, O, and S, and each R²³ can be optionally substituted; R²⁴and R²⁵ are taken together with the nitrogen to which they are attachedto form a 4- to 7-membered monocyclic heterocycloalkyl group, or a 6- to10-membered bicyclic heterocyclic group having fused, spiro, or bridgedrings, and each R²⁴ and R²⁵ can be optionally substituted; R³⁰ isindependently chosen at each occurrence from hydrogen, C₁-C₆alkyl,C₁-C₆haloalkyl, (aryl)C₀-C₄alkyl, (C₃-C₇cycloalkyl)C₀-C₄alkyl,(phenyl)C₀-C₄alkyl, (4- to 7-membered heterocycloalkyl)C₀-C₄alkyl having1, 2, or 3 heteroatoms independently chosen from N, O, and S; (5- or6-membered unsaturated or aromatic heterocycle)C₀-C₄alkyl having 1, 2,or 3 heteroatoms independently chosen from N, O, and S; COOH, Si(CH₃)₃,COOR^(30a), C₂-C₆alkanoyl, —B(OH)₂, —C(O)(CH₂)₁₋₄S(O)R²¹,—P(O)(OR²¹)(OR²²), —P(O)(OR²¹)R²², —P(O)R²¹R²², —NR⁹P(O)(NHR²¹)(NHR²²),—NR⁹P(O)(OR²¹)(NHR²²), —NR⁹P(O)(OR²¹)(OR²²), —C(S)R²¹, —NR²¹SO₂R²²,—NR⁹S(O)NR¹⁰R²², —NR⁹SO₂NR¹⁰R²², —SO₂NR⁹COR²², —SO₂NR⁹CONR²¹R²²,—NR²¹SO₂R²², —C(O)NR²¹SO₂R²², —C(NH₂)NR⁹R²², —C(NH₂)NR⁹S(O)₂R²²,—NR⁹C(O)OR¹⁰, —NR²¹C(O)R²², —(CH₂)₁₋₄C(O)NR²¹R²², —C(O)R²⁴R²⁵,—NR⁹C(O)R²¹, —C(O)R²¹, —NR⁹C(O)NR⁹R¹⁰, —NR⁹C(O)NR²⁴R²⁵,—(CH₂)₁₋₄OC(O)R²¹, each of which R³⁰ can be optionally substituted;R^(3′) is C₁-C₆alkyl, C₂-C₆alkenyl, C₂-C₆alkynyl,(C₃-C₇cycloalkyl)C₀-C₄alkyl-, (aryl)C₀-C₄alkyl-, (3- to 7-memberedheterocycloalkyl)C₀-C₄alkyl-having 1, 2, or 3 heteroatoms independentlychosen from N, O, and S, and (5- or 6-membered unsaturated or aromaticheterocycle)C₀-C₄alkyl having 1, 2, or 3 heteroatoms independentlychosen from N, O, and S, each of which R^(30a) can be optionallysubstituted; L is a bond or is chosen from the formulas

where R¹⁷ is hydrogen, C₁-C₆alkyl, or —C₀-C₄alkyl(C₃-C₇cycloalkyl), andR¹⁸ and R^(18′) are independently chosen from hydrogen, halogen,hydroxymethyl, and methyl; and m is 0, 1, 2, or 3; B is a monocyclic orbicyclic carbocyclic; a monocyclic or bicyclic carbocyclic-oxy group; amonocyclic, bicyclic, or tricyclic heterocyclic group having 1, 2, 3, or4 heteroatoms independently selected from N, O, and S and from 4 to 7ring atoms per ring; C₂-C₆alkenyl; C₂-C₆alkynyl; —(C₀-C₄alkyl)(aryl);—(C₀-C₄alkyl)(heteroaryl); or —(C₀-C₄alkyl)(biphenyl) each of which B isunsubstituted or substituted with one or more substituents independentlychosen from R³³ and R³⁴, and 0 or 1 substituents chosen from R³⁵ andR³⁶; R³³ is independently chosen from halogen, hydroxyl, —COOH, cyano,C₁-C₆alkyl, C₂-C₆alkanoyl, C₁-C₆alkoxy, —C₀-C₄alkylNR⁹R¹⁰, —SO₂R⁹,C₁-C₂haloalkyl, and C₁-C₂haloalkoxy; R³⁴ is independently chosen fromnitro, C₂-C₆alkenyl, C₂-C₆alkynyl, C₁-C₆thioalkyl, -JC₃-C₇cycloalkyl,—B(OH)₂, -JC(O)NR⁹R²³, -JOSO₂OR²¹, —C(O)(CH₂)₁₋₄S(O)R²¹,—O(CH₂)₁₋₄S(O)NR²¹R²², -JOP(O)(OR²¹)(OR²²), -JP(O)(OR²¹)(OR²²),-JOP(O)(OR²¹)R²², -JP(O)(OR²¹)R²², -JOP(O)R²¹R²², -JP(O)R²¹R²²,-JSP(O)(OR²¹)(OR²²), -JSP(O)(OR²¹)(R²²), -JSP(O)(R²¹)(R²²),-JNR⁹P(O)(NHR²¹)(NHR²²), -JNR⁹P(O)(OR²¹)(NHR²²), -JNR⁹P(O)(OR²¹)(OR²²),-JC(S)R²¹, -JNR²¹SO₂R²², -JNR⁹S(O)NR¹⁰R²², -JNR⁹SO₂NR¹⁰R²²,-JSO₂NR⁹COR²², -JSO₂NR⁹CONR²¹R²², -JNR²¹SO₂R²², -JC(O)NR²¹SO₂R²²,-JC(NH₂)NR²², -JC(NH₂)NR⁹S(O)₂R²², -JOC(O)NR²¹R²², -JNR²¹C(O)OR²²,-JNR²¹OC(O)R²², —(CH₂)₁₋₄C(O)NR²¹R²², -JC(O)R²⁴R²⁵, -JNR⁹C(O)R²¹,-JC(O)R²¹, -JNR⁹C(O)NR¹⁰R²², —CCR²¹, —(CH₂)₁₋₄OC(O)R²¹, and -JC(O)OR²³;each of which R³⁴ may be unsubstituted or substituted with one or moresubstituents independently chosen from halogen, hydroxyl, nitro, cyano,amino, oxo, —B(OH)₂, —Si(CH₃)₃, —COOH, —CONH₂, —P(O)(OH)₂, C₁-C₆alkyl,—C₀-C₄alkyl(C₃-C₇cycloalkyl), C₁-C₆alkoxy, —C₀-C₂alkyl(mono- anddi-C₁-C₄alkylamino), C₁-C₆alkylester, C₁-C₄alkylamino,C₁-C₄hydroxylalkyl, C₁-C₂haloalkyl, and C₁-C₂halo alkoxy; R³⁵ isindependently chosen from naphthyl, naphthyloxy, indanyl, (4- to7-membered heterocycloalkyl)C₀-C₄alkyl containing 1 or 2 heteroatomschosen from N, O, and S, and bicyclic heterocycle containing 1, 2, or 3heteroatoms independently chosen from N, O, and S, and containing 4- to7-ring atoms in each ring; each of which R³⁵ is unsubstituted orsubstituted with one or more substituents independently chosen fromhalogen, hydroxyl, nitro, cyano, C₁-C₆alkyl, C₂-C₆alkenyl,C₂-C₆alkanoyl, C₁-C₆alkoxy, (mono- and di-C₁-C₆alkylamino)C₀-C₄alkyl,C₁-C₆alkylester, —C₀-C₄alkyl(C₃-C₇cycloalkyl), —SO₂R⁹, C₁-C₂haloalkyl,and C₁-C₂haloalkoxy; and R³⁶ is independently chosen from tetrazolyl,(phenyl)C₀-C₂alkyl, (phenyl)C₁-C₂alkoxy, phenoxy, and 5- or 6-memberedheteroaryl containing 1, 2, or 3 heteroatoms independently chosen fromN, O, B, and S, each of which R³⁶ is unsubstituted or substituted withone or more substituents independently chosen from halogen, hydroxyl,nitro, cyano, C₁-C₆alkyl, C₂-C₆alkenyl, C₂-C₆alkanoyl, C₁-C₆alkoxy,(mono- and di-C₁-C₆alkylamino)C₀-C₄alkyl, C₁-C₆alkylester,—C₀-C₄alkyl(C₃-C₇cycloalkyl), —SO₂R⁹, —OSi(CH₃)₂C(CH₃)₃,—Si(CH₃)₂C(CH₃)₃, C₁-C₂haloalkyl, and C₁-C₂haloalkoxy; and J isindependently selected at each occurrence from a covalent bond,C₁-C₄alkylene, —OC₁-C₄alkylene, C₂-C₄alkenylene, and C₂-C₄alkynylene. 2.A pharmaceutical composition comprising an effective amount of acompound of claim 1 in a pharmaceutically acceptable carrier.
 3. Amethod for the treatment of a disorder mediated by the complementpathway, comprising administering an effective amount to a host in needthereof of a compound of claim 1, optionally in a pharmaceuticallyacceptable carrier.
 4. The method of claim 3, wherein the host is ahuman.
 5. The method of claim 3, wherein the complement mediated pathwayis age-related macular degeneration (AMD).
 6. The method of claim 3,wherein the complement mediated pathway is retinal degeneration.
 7. Themethod of claim 3, wherein the complement mediated pathway is anophthalmic disease.
 8. The method of claim 3, wherein the complementmediated pathway is paroxysymal nocturnal hemoglobinuria (PNH).
 9. Themethod of claim 3, wherein the complement mediated pathway is multiplesclerosis.
 10. The method of claim 3, wherein the complement mediatedpathway is arthritis.
 11. The method of claim 3, wherein the complementmediated pathway is rheumatoid arthritis.
 12. The method of claim 3,wherein the complement mediated pathway is a respiratory disease or acardiovascular disease.
 13. The compound of claim 1, wherein the

ring is selected from:

wherein q is 0, 1, 2 or 3, and r is 1, 2 or 3; R and R′ areindependently chosen from H and optionally substituted alkyl,cycloalkyl, cycloalkylalkyl, heterocycle, heterocycloalkyl, aryl,arylalkyl, heteroaryl and heteroarylalkyl; and, Z is F, Cl, NH₂, CH₃,CH₂D, or CD₃.
 14. The compound of claim 1, wherein R′ and R^(1′) or R³and R^(3′) can together form an optionally substituted 3- to 6-memberedcarbocyclic spiro ring or a 3- to 6-membered heterocyclic spiro ringcontaining 1 or 2 heteroatoms independently chosen from N, O, or S. 15.The compound of claim 1, wherein R² and R^(2′) can together to form anoptionally substituted 3- to 6-membered carbocyclic spiro ring; or R²and R^(2′) are taken together to form a 3- to 6-membered heterocyclicspiro ring.
 16. The compound of claim 1, wherein -L-α— is selected from:

wherein R¹⁸ and R^(18′) are independently chosen from hydrogen, halogen,hydroxymethyl, and methyl; m is 0 or 1; and R²⁶, R²⁷, and R²⁸ areindependently chosen from hydrogen, halogen, hydroxyl, nitro, cyano,C₁-C₆alkyl, C₂-C₆alkenyl, C₂-C₆alkanoyl, C₁-C₆alkoxy, C₁-C₆thioalkyl,(mono- and di-C₁-C₆alkylamino)C₀-C₄alkyl, (C₃-C₇cycloalkyl)C₀-C₄alkyl,(aryl)C₀-C₄alkyl-, (heteroaryl)C₀-C₄alkyl-, and—C₀-C₄alkoxy(C₃-C₇cycloalkyl); each of which R²⁶, R²⁷, and R²⁸ otherthan hydrogen, halogen, hydroxyl, nitro, cyano, is unsubstituted orsubstituted with one or more substituents independently chosen fromhalogen, hydroxyl, amino, C₁-C₂alkoxy, C₁-C₂haloalkyl,(C₃-C₇cycloalkyl)C₀-C₄alkyl-, and C₁-C₂haloalkoxy; and R²⁹ is hydrogen,C₁-C₂alkyl, C₁-C₂haloalkyl or —Si(CH₃)₂C(CH₃)₃.
 17. The compound ofclaim 1, wherein B is selected from:

wherein R^(2′) is hydrogen, methyl, or trifluoromethyl; R²⁸ is hydrogenor halogen; and R²⁹ is hydrogen, methyl, trifluoromethyl, or—Si(CH₃)₂C(CH₃)₃.
 18. The compound of claim 1, wherein R³² is selectedfrom

wherein R¹⁰⁰ is aryl, heteroaryl, alkyl, cycloalkyl, heterocyclic,alkenyl or alkynyl.